A Case of Rupture of the Accessory Spleen caused by the Torsion

Naoto Nishigori, Yukio Aomatsu, Heisuke Fujimoto, Takashi Inoue, Hirofumi Kuwata and Yoshiyuki Nakajima*

Department of Surgery, Matsubara Municipal Hospital
Department of Surgery, Nara Medical University*

An accessory spleen is found in 10-30% of necropsies. We report a very rare case of rupture accessory spleen rupture caused by torsion. A 32-year-old man suffering severe left abdominal pain was found in laboratory findings to have progressive anemia and in computed tomography and angiography to have a mass 15 cm in diameter in the bursa omentalis, with the main artery fed from the splenic artery. Preoperative diagnosis was a ruptured splenic tumor. On laparotomy, we found an accessory spleen 7 cm in diameter in front of the pancreas. The stalk derived from the splenic artery and vein was twisted 720 degrees. Rupture of the accessory spleen had caused abdominal pain and anemia, so we resected the accessory spleen. Infarction and rupture of the accessory spleen caused by torsion, although very rare, should be taken into account as a differential diagnosis in acute abdomen in the young.

Key words
accessory spleen, torsion, rupture

Reprint requests
Naoto Nishigori Department of Surgery, Nara Prefectural Hospital
1-30-1 Hiramatsu, Nara, 631-0846 JAPAN

Accepted
November 22, 2006

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