Torsion of an Accessory Spleen; Diagnosed Preoperatively and Excised Laparoscopically

ABSTRACT

We report on a case of torsion of an accessory spleen occurring in a 19-year-old female. She was admitted with a three-day history of left-upper quadrant pain that became slowly aggravated. On physical examination, left-side abdominal tenderness was observed, most markedly in the left upper quadrant, but no rebound tenderness was noted. Contrast-enhanced computed tomography (CT) scan showed a non-enhancing mass with a tubular vascular pedicle and normal enhancing spleen in the left upper abdomen. Doppler ultrasound showed no vascular flow within the hypoechoic mass in the left upper abdomen. Torsion of an accessory spleen was suspected, and emergent laparoscopic exploration was performed. Laparoscopic exploration showed a large rounded violet mass with a tw isted vascular pedicle, located anterior to the normal spleen. The mass was excised laparoscopically and then removed through a 2.5 cm extended incision of the left-sided trocar incision. Postoperative recovery was normal and she was discharged on the fifth postoperative day.