Abdominal splenosis

Case contributed by Morouj Shaggah
Diagnosis almost certain

Presentation

Diffuse abdominal pain. History of splenectomy after RTA.

Patient Data

Age: 65 years
Gender: Male

Abdomen CT with contrast

ct

Absent spleen (history of splenectomy).

Multiple well-defined intraperitoneal lesions of various sizes are seen, with density and enhancing characteristics similar to normal splenic tissue. They are seen at splenic bed, some are peritoneal based, on omentum and the largest is in the rectovesical pouch.

A unilocular cystic lesion with eggshell calcification is seen in the tail of pancrease, with atrophic changes in the tail of pancreas without evidence of ductal dilation.

Case Discussion

In keeping with the patient's history of splenectomy after splenic injury, these lesions result from seeding of the peritoneal cavity with splenic tissue; splenosis

Regarding the cystic pancreatic lesion, the diagnosis of pancreatic pseudocyst was preffered in context with pancreatic tail atrophy and previous abdominal trauma , however, no clear history of pancreatitis was obtained, further work up was advised to confirm the diagnosis and rule out other differentials ( cystic lesions of the pancreas ). 

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