Small bowel obstruction due to splenosis 30 years after splenectomy

Abstract

Splenosis is the autotransplantation of splenic tissue into abnormal locations due to trauma or iatrogenically. Usually, this causes no symptoms, but in rare cases the mass effect of the transplanted nodules can cause small bowel obstruction. Resection of the culprit splenic tissue is recommended, but not more extensive dissection of non-involved nodules. Our patient presented at 43 years of age with abdominal pain, distention and bilious vomiting. He had undergone a splenectomy at the age of 13 years due to splenic rupture after a motor vehicle collision. Computed tomography demonstrated a small bowel obstruction with multiple nodules suspicious of splenosis. The obstructing mass and compromised bowels. were resected. Final pathology confirmed the diagnosis. Splenosis is an uncommon aetiology of small bowel obstruction and must be considered in patients who had previous splenic trauma or surgery.

Cecal splenosis mimicking gastrointestinal stroma tumor. Case report and review of the literature

“…Gastrointesitnal bleeding occurs when splenic tissue is located within the bowel wall and through intestinal mucosae. Bowel obstruction caused by bridges and adhesions between splenic implants in mesentery and bowel wall has been reported [ 11 , 12 ]. However, bowel obstruction due to adhesions could be triggered not by the splenosis itself, but by a previous splenectomy, making splenosis an incidental finding after all [ 13 ].…”

Splenosis: fetters of the unknown or step through existing precautions (part I)

“…Помимо посттравматического генеза спленоз может иметь ятрогенный характер в случае целенаправленной аутотрансплантации ткани селезенки при необходимости удаления данного анатомического образования, проводящейся с целью профилактики постспленэктомического синдрома. Как правило, регенераторные очаги селезеночной ткани локализуются на париетальной и висцеральной брюшине, в ложе удаленной селезенки, но могут обнаруживаться во всем теле (даже в головном мозге), в различном количестве и разнообразных размеров [1][2][3][4][5].…”

Splenic scintigraphy—reloaded: Pulmonary and pleural lesions proven to be splenosis by heat-damaged erythrocyte scintigraphy

“…Usually splenosis is an asymptomatic benign traumatic or iatrogenic acquired condition characterized by the presence of heterotopic viable splenic tissue in other body compartment (abdominal or in the chest) or organs than the regular intraperitoneal spleen pouch [1] , [2] , [3] . The term "splenosis" was first introduced by Buchbinder and Lipkoff in1939 [4] .…”