Torsion of Wandering Accessory Spleen: Laparoscopic Surgery

Lee, Yoon Suk; Kim, Jin Jo; Lee, Geun Ho; Oh, Se Jung; Park, Seung Man; Kim, Young Ha

Abstract

Accessory spleen is presence of ectopic splenic sue, which has been found in 10~30% in autopsies series. Commonly accessory spleen have no clinical symptoms so diagnosis is difficult to make. But torsion of an wandering accessory spleen which is very unusual entity can appeared as acute abdominal pain and painful mass on abdomen. We reported case of a 27-years-old-woman with torsion of an wandering accessory spleen presenting as acute abdominal pain and painful mass on abdomen. Abdomino-pelvic CT shows large hypodense mass with peripheral enhancement with inflammatory change in LLQ area. Patient underwent laparoscopic exploration under impression of torsion of mesenteric cyst. During the laparoscopic exploration, we found out the torsion of accessory spleen and it was removed successfully by laparoscopic approach. The diagnosis of torsion of wandering accessory spleen could be considered in acute abdomen with intraabdominal mass with hypodense, peripheral enhancement on CT. Despite of size of mass, laparoscopic approach is one of the treatment method in that case.