A Case of Torsion of Accessory Spleen

Hideto Fujita, Masahumi Inokuchi, Keiko Iwata, Hideyuki Ajisaka, Seiichi Yamamoto, Masahide Kaji, Kiichi Maeda, Kazuhisa Yabushita, Kohji Konishi and Akio Uchiyama^*

Department of Surgery and Clinical Laboratory^*, Toyama Prefectural Central Hospital

An accessory spleen is found in 10∼30% of necropsies, but seldom gives rise to symptoms and very rarely involves torsion. We treated a patient with such torsion. A 23-year-old man was admitted due to intermittent abdominal pain and fever. Laboratory findings showed leukocytosis. Abdominal ultrasonography, computed tomography, and magnetic resonance imaging revealed a solid tumor in the left upper abdominal quadrant. Preoperative diagnosis was an abdominal tumor. Explorative laparotomy showed a solid tumor in the greater omentum, 8.0×7.2×4.8 cm. It had a long twisted pedicle connected to the gastroepiploic artery and vein. Macroscopically, the tumor was homogenous, dark red, and solid tumor. Microscopically, it contained splenic tissue with necrosis and fibrosis. The final diagnosis was torsion of an accessory spleen with infarction, causing abdominal pain. It should be considered in the differential diagnosis of intraabdominal mass with abdominal pain in adolescents.

Key words
accessory spleen, torsion, abdominal pain

Reprint requests
Hideto Fujita Department of Surgery, Toyama Prefectural Central Hospital 2-2-78, Nishinagae, Toyama, 930-8550 JAPAN

Accepted
September 19, 2001

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