Torsion of an accessory spleen in an elderly patient

Hems, Tim; Bellringer, James

doi:10.1136/pgmj.66.780.838

Cited by 19 publications

(17 citation statements)

References 4 publications

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“…Torsion of an accessory spleen leading to acute abdomen has been reported in literature since Alexander and Romanes first reported it in 1914 [ 7 ]. Torsion of an accessory spleen with resultant infarction may cause an acute abdomen at any age [ 8 ]. It is an extremely rare entity that is rarely diagnosed preoperatively [ 2 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

Torsion of an accessory spleen: a rare case preoperatively diagnosed and cured by single-port surgery

et al. 2015

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We report a very rare case of acute abdomen caused by torsion of an accessory spleen that was preoperatively diagnosed and cured by single-port surgery. A 31-year-old woman was admitted to our hospital with severe left abdominal pain. Physical examination revealed a left upper quadrant abdominal tenderness with voluntary guarding. Ultrasound demonstrated a well-defined round mass isoechoic to the spleen, measuring 3.0 cm in diameter in the left upper quadrant adjacent to the spleen. A contrast-enhanced CT scan showed a normally enhanced spleen and a 3.0 × 3.0, hypodense, non-enhancing mass anterior to the spleen with a twisted funicular structure. Torsion of an accessory spleen was suspected, and emergency single-port surgery was performed. During surgery, a rounded violet mass measuring 3.0 cm in diameter, suggestive of an accessory spleen, with a 1800° torsion around a long vascular pedicle along the left side of the greater omentum was discovered. The mass was removed and post-operative recovery was uneventful. A review of the literature revealed 26 cases (including ours) of torsion of an accessory spleen in English. Even with the recent advances in radiologic imaging modalities, making a preoperative diagnosis of this is difficult and most cases are diagnosed during laparotomy. This is the first report preoperatively diagnosed and cured by single-port surgery. We decided to start the operation by using a single port, not only for cosmetic reasons for this young female patient, but also for final confirmation of our diagnosis. We believe that single-port laparoscopy is valuable as a diagnostic tool as long as safety is assured for patients with acute abdomen. Although torsion of an accessory spleen is extremely rare, it should be considered in the differential diagnosis of acute abdomen in children and young adults.Electronic supplementary materialThe online version of this article (doi:10.1186/s40792-015-0101-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Torsion of an accessory spleen: a rare case preoperatively diagnosed and cured by single-port surgery

et al. 2015

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“…Hemorrhage and spontaneous rupture usually occur due to trauma or enlargement of the accessory spleen from hematologic disorders, infectious mononucleosis, or malaria ( 2 ). Hemorrhage and spontaneous rupture can also occur as a result of venous congestion and torsion of an accessory spleen ( 10 , 11 ). Rarely, hemorrhage and spontaneous rupture occur in otherwise normal accessory spleens ( 12 , 13 ).…”

Section: Discussionmentioning

confidence: 99%

Torsion of an accessory spleen: Case report and review of the literature

Sadro¹,

Lehnert²

2013

Radiology Case Reports

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Torsion of an accessory spleen is an uncommon cause of abdominal pain. Only a few cases have been reported in the literature. Most cases occur in children, and in most cases the diagnosis is made at surgery. We report a case of torsion of an accessory spleen in an adult female who presented with acute left-flank pain. The diagnosis was made on contrast-enhanced computed tomography (CT) and was confirmed at surgery. Without treatment, torsion of an accessory spleen can lead to hemorrhagic shock, peritonitis, and bowel obstruction. It is useful for the radiologist to make this diagnosis on imaging so that biopsy can be avoided and surgery performed to avoid complications.

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“…Venous return is disrupted first, causing hemorrhagic infarction of the parenchyma, which may lead to spontaneous rupture and death [13] , [15] . The scenario in our case was typical for torsion and vascular compromise manifested in the form of severe, progressive and non-relenting abdominal pain [16] , [17] .…”

Section: Discussionmentioning

confidence: 76%

“…Accessory spleens are a common pathology, and are considered a variation of normal development of the spleen. It is seen in 10%-20% of patients at autopsy and in 16% of patients undergoing contrast-enhanced CT of the abdomen [6] . According to the literature there is an increased incidence of accessory spleens in patients with hematologic disorders.…”

Section: Discussionmentioning

confidence: 99%

Torsion of huge wandering accessory spleen. Case report and review of literature

Termos

Redha

Zbibo

et al. 2017

International Journal of Surgery Case Reports

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Torsion of an accessory spleen in an elderly patient

Abstract: Torsion of an accessory spleen is recognized as a rare cause of acute abdominal pain in childhood. A case is reported which, however, is unusual in that it occurred in a patient of 75, who had had no previous symptoms which might have suggested the presence of an accessory spleen.

Cited by 19 publications

References 4 publications

Torsion of an accessory spleen: a rare case preoperatively diagnosed and cured by single-port surgery

Torsion of an accessory spleen: a rare case preoperatively diagnosed and cured by single-port surgery

Torsion of an accessory spleen: Case report and review of the literature

Torsion of huge wandering accessory spleen. Case report and review of literature

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