Splenunculus can mimic acute abdomen: Its clinical and surgical relevance

Abstract

Congenital accessory spleen or splenunculi is a small mass of splenic tissue that failed to fuse with the primary spleen during embryogenesis. The overall prevalence of splenunculus in 14.5% in the literature. Splenunculus is usually asymptomatic in most of the individuals and diagnosed incidentally during the abdominal imaging, laparotomy or necropsy. Rarely it might present as an acute abdomen in case of torsion or infract. Few cases of malignant changes in the accessory spleen are also reported. Surgeons need to be aware of such small masses of splenic tissue during splenectomy, if they are left unnoticed after total splenectomy, it may lead to the recurrence of hematological disorders. In the present case report, the authors described an isolated, solitary splenunculus in a 55 years old male cadaver found during dissection. KEY WORDS: Accessory spleen, Splenunculi, Splenectomy, Splenosis, Torsion.

Splenunculus mimicking splenomegaly in a patient with synchronous herpes simplex 1 viremia and myelosuppression

“…13,14 It is noteworthy that a splenunculus is vastly asymptomatic and should not mimic physical examination findings of splenomegaly, which demonstrates the rarity of our case. 1,2 Despite these factors, clinicians should consider a splenunculus as a cause for an abdominal mass in the LUQ which would require imaging to further characterize to avoid unnecessary medical and surgical management.…”

“…A splenunculus is a normal anatomical variant found commonly in the general population characterized by a non‐palpable spleen 1,2 . The presenting population are generally asymptomatic, and the diagnosis is made on incidental imaging 1,2 .…”

“…A splenunculus is a normal anatomical variant found commonly in the general population characterized by a non‐palpable spleen. 1 , 2 The presenting population are generally asymptomatic, and the diagnosis is made on incidental imaging. 1 , 2 Current literature either presents wide varying estimates of the prevalence data or inconclusive epidemiological data on accessory spleens in the general population.…”

“… 1 , 2 The presenting population are generally asymptomatic, and the diagnosis is made on incidental imaging. 1 , 2 Current literature either presents wide varying estimates of the prevalence data or inconclusive epidemiological data on accessory spleens in the general population. 3 However, a major systematic review exploring 81 studies pinpointed a prevalence rate of 14.5% with majority of them being in close proximity to the splenic hilum.…”

“…4 , 5 , 6 Misdiagnosis can be disastrous as it can lead to inappropriate diagnostic pathways and management algorithms such as a splenectomy leading to neutropenia, causing great harm to the patient. 1 , 2 , 3 …”