Torsion of accessory spleen in children: three case reports and literature review

Nguyen Huu Chi1, Do Thanh Thuy1, Le Cam Thach1, Vo Ha Nhat Thuy1, Huynh Nhat Hanh Nhan1,
1 Department of Ultrasound, Hospital Children I

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Abstract

SUMMARY


Objectives: To present sonographic findings of torsion of accessory spleen.
Methods: Three case reports.
Results: Case 1: A 2-year-old girl presented with a twoday history of left abdominal pain. Ultrasound revealed a solid, hypoechoic and avascular mass below the lower pole of the spleen. Case 2: A 14-year-old boy presented with 10 days of intermittent left upper quadrant pain. Ultrasound showed a solid, heterogeneous and hypoechoic mass below the lower pole of the spleen. This mass had poor vascularity, some small peripheral vessels, whirlpool sign at the hilum and vascular dilatation at the lower pole of the spleen. Case 3: An 8-month-old boy, ultrasound showed a hypoechoic, avascular mass in the right upper quadrant near the main spleen with hyperechogenicity of the surrounding omentum. In all three cases, we diagnosed torsion and necrosis of accessory spleen. Surgical and pathologic results confirmed the diagnosis.
Conclusions: Torsion of accessory spleen is an extremely rare entity. It may manifest as acute or subacute abdominal pain. USG is a simple and exact procedure if we consider it.

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References

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