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J Korean Soc Emerg Med > Volume 15(4); 2004 > Article
Journal of The Korean Society of Emergency Medicine 2004;15(4): 300-303.
Torsion of an Accessory Spleen Presenting as an Acute Abdomen: A Case Report
Ki Myoung Kim, Young Min Kim, Si Kyoung Jeong, Woon Jeong Lee, Tae Yong Hong, Won Jae Lee, Se Kyung Kim
Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. emart@catholic.ac.kr
ABSTRACT
An accessory spleen is often incidentally discovered in up to 20% of autopsies. However, it is exceedingly rare for this condition to result in an acute abdomen. In addition, torsion of an accessory spleen is extremely rare. In spite of this, the entity should be considered in the emergency department in the differential diagnosis of an acute abdomen associated with an intraperitoneal inflammatory mass. This report describes a case of acute torsion of an accessory spleen. A 26-year-old, previously health female was admitted to our hospital with severe abdominal pain and a palpable mass. Ultrasonography showed a well-defined ovoid, hypoechogenic, avascular mass. Computed tomography demonstrated a round, homogeneous hypodense mass with a whorling appearance and an engorged vascular structure in the left side of the mass. The presumptive diagnosis of a large exoenteric mass (small bowel or mesenteric origin) associated with mesenteric volvulus was made preoperatively. However, at laparotomy, the patient was found to have torsion and an infarction of an accessory spleen that had twisted on its long vascular pedicle.
Key words: Spleen, Acute abdomen, Torsion
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