J Korean Surg Soc.  2009 May;76(5):326-328. 10.4174/jkss.2009.76.5.326.

Spontaneous Rupture of Accessory Spleen Detected during Laparoscopic Cholecystectomy

• Lee SE
• Jang JY
• Hwang DW
• Lim CS
• Kim SW

• KMID: 2096554
• DOI: http://doi.org/10.4174/jkss.2009.76.5.326

Abstract

Splenic rupture during laparoscopic cholecystectomy is a rare and unusual complication. We report a case of accessory splenic rupture that occurred during laparoscopic cholecystectomy. A 63-year-old male patient underwent laparoscopic cholecystectomy due to acute cholecystitis. After pneumoperitoneum was established, hemoperitoneum was detected. However, a bleeding focus was not found by laparoscopic whole abdominal exploration after laparoscopic cholecystectomy. Twenty-four hours later the patient became hypotensive and laparoscopic reexploration was performed. Hematoma and omental adhesion was detected around accessory spleen. Laparoscopic accessory splenectomy was performed. Distortion or stretching of perisplenic adhesion due to the induction of pneumoperitoneum possibly resulted in sudden splenic rupture and hemoperitoneum.

Keyword

Accessory spleen; Pneumoperitoneum; Laparoscopic cholecystectomy

MeSH Terms

Cholecystectomy, Laparoscopic
Cholecystitis, Acute
Hematoma
Hemoperitoneum
Hemorrhage
Humans
Male
Middle Aged
Pneumoperitoneum
Rupture, Spontaneous
Spleen
Splenectomy
Splenic Rupture

Figure

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  Fig. 1 CT scan showing large stone in the neck of the gallbladder with edematous wall and mild pericholecystic fat infiltration.

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  Fig. 2 CT scan showing 8.5 cm sized accessory spleen in the left upper quadrant.

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