Infarcted accessory spleen masquerading as a mesenteric cyst

Abstract

An accessory spleen is a rare entity which is usually asymptomatic. When symptomatic, it presents as an acute abdomen, with either torsion, rupture or haemorrhage. We present the case of a 20-year-old man who presented with chronic lower abdominal pain since 3 months and a lump in the left lower quadrant. On clinical examination and investigations, the lump was diagnosed as a mesenteric cyst, and an uncomplicated laparoscopic excision was performed. The postoperative histopathological examination reported it as an infarcted accessory spleen.

Acute Abdominal Pain due to Accessory Splenic Infarction in an Adult: A Case Report

“…Several case reports (n=8) on accessory spleens complicated by torsion or infarction have been found, which are summarized in Table 1. [7][8][9][10][11][12][13][14] A diagnosis of an accessory spleen is usually made in childhood (median age 12 years, range 5-75 years) and six patients were younger than 10 years of age. This may be because accessory spleens tend to atrophy as children grow.…”

“…The differential diagnoses in such cases include mesenteric cyst, enteric duplication cyst, or lymphatic cyst. 11 MRI can evaluate the components of the tumor by scintigraphy using Tc-99m-labelled phytate, or heat-damaged red blood cells can be used to detect splenic tissue and is helpful in the diagnosis of a functional accessory spleen. 17 Nevertheless, minimally functioning splenic tissue can result in false-negative findings, and small lesions may be missed due to the low image resolution.…”