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Preoperative diagnosis of a torsioned accessory spleen


1 Departments of Radiology, University of Tsukuba Hospital, Tsukuba, Japan
2 Department of Radiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
3 Department of Radiology, University of Tsukuba Hospital, Tsukuba, Japan
4 Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

Correspondence Address:
Miki Yoshida,
Departments of Radiology, University of Tsukuba Hospital, Tsukuba, Ibaraki
Japan
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Source of Support: None, Conflict of Interest: None

We report a case of a 12-year-old boy with an accessory spleen torsion. He presented with left-sided abdominal pain after trauma. A 4 cm oval mass withoutcontrast enhancement was detected on contrast-enhanced computed tomography (CT), and ultrasound (US) showed a 4 cm oval mass below the spleen. The mass mainly consisted of high echoes similar to the spleen; the central part showed irregularly low echoes. Subsequent follow-up daily US examinations showed gradual expansion of the central low echoes with conspicuous hyperechoic dots. Discontinuation of the branch from the splenic artery to the mass was observed, both, on US and CT. These findings led to the diagnosis of a hemorrhagic infarct caused by torsion of the accessory spleen. Laparoscopy showed adherence of the accessory spleen to the omentum and colon by twisting four times around its axis. It was resected and confirmed the diagnosis of a torsioned accessory spleen.


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    -  Yoshida M
    -  Saida T
    -  Masuoka S
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