Unexpected post-operative haemorrhage: Could it be splenosis?

Abstract

Ectopic splenic tissue can be classified as accessory spleen, polysplenia or a phenomenon termed as splenosis. Once believed a rare occurrence, the incidence of splenosis is now thought to be significantly higher. Generally, splenosis is asymptomatic and discovered incidentally during operation, imaging or at autopsy. The case presented herein describes an incidental finding of an intraabdominal splenosis, which was subsequently biopsied to investigate for peritoneal metastatic disease. The biopsied tissue subsequently caused significant post-operative haemorrhage. Past medical history and specific pre-operative imaging modalities for patients presenting with asymptomatic peritoneal or intra-abdominal nodules are discussed. Splenosis is highlighted as a common condition to consider prior to invasive investigations.

A case of spontaneous abdominal hemoperitoneum secondary to ruptured splenosis

“…Splenosis is thought to occur through the seeding of fragments of splenic tissue throughout a cavity during traumatic or iatrogenic compromise of the splenic capsule, with implants recruiting blood supply from local tissues and vessels to form nodules [ 6 , 7 ]. Another hypothesis offers an alternative mechanism of hematogenous spread and seeding of splenic tissue [ 8 ].…”