Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Aug 7, 2009; 15(29): 3684-3686
Published online Aug 7, 2009. doi: 10.3748/wjg.15.3684
What is a reliable CT scan for diagnosing splenosis under emergency conditions?
Francesco Giuseppe Garaci, Michele Grande, Massimo Villa, Stefano Mancino, Daniel Konda, Grazia Maria Attinà, Gabriele Galatà, Giovanni Simonetti
Francesco Giuseppe Garaci, Stefano Mancino, Daniel Konda, Giovanni Simonetti, Department of Diagnostic Imaging and Interventional Radiology, University Hospital of Tor Vergata, viale Oxford 81, 00133 Rome, Italy
Michele Grande, Massimo Villa, Grazia Maria Attinà, Gabriele Galatà, Department of Surgery, University Hospital of Tor Vergata, viale Oxford 81, 00133 Rome, Italy
Author contributions: All authors contributed in editing the manuscript; All authors approved the final version of the manuscript.
Correspondence to: Massimo Villa, PhD, Department of Surgery, University Hospital of Tor Vergata, viale Oxford 81, 00133 Rome, Italy. villamassimo@inwind.it
Telephone: +39-6-20902976
Fax: +39-6-20902976
Received: March 21, 2009
Revised: June 30, 2009
Accepted: July 7, 2009
Published online: August 7, 2009
Abstract

Splenosis is a condition in which splenic tissue is present in a non-anatomical position. Implants of splenic tissue can mimic neoplasms and only specific examinations can confirm the correct diagnosis. Here we report a case of a 23-year-old male patient with a history of surgical splenectomy during childhood after trauma. He was admitted to the emergency department with acute bowel obstruction. An abdominal-pelvic computed tomography (CT) scan revealed small bowel obstruction and the presence of two rounded, solid masses located in the rectal-vescical pouch. Quantitative analyses of the different density values in the arterial phase and early portal venous phase demonstrated that these lesions were highly vascularised (92 and 97 Hounsfield Units, respectively). The hypothesis of an ectopic splenic mass was made after evaluation of the CT images and clinical history. The acute bowel obstruction caused by adhesive intestinal syndrome was resolved by surgical adhesiolysis. The smallest mass adherent to the rectum was removed. Histopathologic examination confirmed the benign nature of the lesion, which consisted of splenic tissue.

Keywords: Splenosis; Ectopic splenic tissue; Computed tomography scan; Splenectomy; Emergency