An accessory spleen is defined as ectopic splenic tissue that develops due to failure of fusion of cells during embryonic development as they migrate from the midline to the left upper quadrant. While benign, complications may arise which include trauma, torsion, or infarction of the ectopic tissue. Additionally, patients who have had a splenectomy secondary to treatment for previous pathology such as a haematological malignancy or idiopathic thrombocytopenia purpura may experience persistent symptoms due to the accessory splenic tissue. The presence of an accessory spleen is therefore of significant diagnostic and therapeutic importance. To the best of the authors' knowledge, this case is the second and largest reported case of a giant right suprarenal accessory spleen and highlights the difficulty in differentiation of these masses from malignant adrenal tumours.

Highlights Cardiac rupture is a full thickness laceration of the myocardium that occurs after blunt chest trauma. They are notoriously fatal, with only a handful of patients documented to have survived this injury. In cases where there is laceration of the pericardium, cardiac injury may not be obvious on initial assessment. A high degree of suspicion along with early recognition and prompt operative intervention can reduce mortality for these disastrous injuries. Despite its rarity, a differential diagnosis of cardiac rupture should be entertained in patients with low velocity blunt chest trauma who present with haemothorax.

HighlightsThe CT scan finding of sigmoid volvulus is closely resembles to the percussion instrument known as “steel pan”.This Steel pan sign has not yet been described in the literature for sigmoid volvulus.The sign is easier to recognize on CT scan of the abdomen and in some cases on plain abdominal X- rays.This easily recognized symbol enables faster diagnosis and earlier treatment of this disease, thus reducing the morbidity and mortality.

No abstract