Considering her history, we diagnosed it as a compensatory accessory spleen
The spleen was completely placed in a specific bag, and, after centimetric accessory spleen
removal, we sent it to the Department of Pathology of our hospital structure for histological examination.
The treatment modality can range from 'no treatment required' to major surgeries and thus it becomes imperative to diagnose an accessory spleen
even if it is done only with an intention to rule out grave pathology.
Splenules, or accessory spleens
, are congenital foci of normal splenic tissue that are separate from the main body of the spleen.
(1,3) However, these benign lesions rarely occur in intrapancreatic accessory spleen
. To our knowledge, only 27 cases have been reported in English literature so far.
No ultrasonographic differences exist between the accessory spleen
and normal testis.
Choi, "Differentiation of an intrapancreatic accessory spleen
from a small (<3-cm) solid pancreatic tumor: value of diffusion-weighted MR imaging," Radiology, vol.
Ultrasound usually shows an accessory spleen
as a round, mildly echogenic mass with homogenous texture and posterior enhancement .
After laparoscopic examination to search for an accessory spleen
, the dissection began at splenic flexure with a harmonic ultrasonic dissector.
(4) Also, two patients had the accessory spleen
close to the hilum of the spleen and one had two accessory spleens
Three cases of accessory spleen
(15%) missed by the pre-operative CT scan were discovered at the beginning of the laparoscopic session and removed, 3 patients with symptomatic cholelithiasis had concomitant laparoscopic cholecystectomy without any additional morbidity, 1 patient had prolonged postoperative ileus that resolved after 3 days, and 1 patient had wound infection at the umbilical incision with no consequences.
On the other hand, the failure of fusion of splenic tissue results in the formation of accessory spleens
, and detection of an accessory spleen
is important for hematological conditions.
Case 1, intrapancreatic accessory spleen
; Case 2, pancreatic glucagonoma
, found in 10%-30% of patients at autopsy, is due to the fusion failure of the splenic anlage, which is located in the dorsal mesogastrium.
, in other words supernumerary spleens, splenunculi, or splenules, results from the failure of fusion of the primordial splenic buds in the dorsal mesogastrium during the fifth week of fetal life.