Wandering accessory spleen
Citation, DOI & case data
Chronic left hypochondrial pain four months ago.
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Triphasic CT abdomen revealed a well-defined homogeneously enhancing oval-shaped soft tissue seen in the left hypochondrial region, measuring 4.3x5.3 x5.2 cm (AP xTr X CC respectively).
The pre-contrast study shows fine foci of calcification. After IV contrast, it shows homogenous enhancement similar to spleen with tigroid appearance.
It is seen as separable from inflated descending colon loops and indenting-related jejunal loops.
On MIP images, the feeding artery is seen arising from the splenic artery and the veins drain into the splenic vein.
Wandering accessory spleen is a challenging radiological diagnosis. It has several differential diagnoses including; GIST, lymphoma, and peritoneal metastasis 1.
This case shows a left hypochondrial mass with a vascular pedicle connected to the splenic vessels (Jokari sign) 2.
Complications include; hemorrhage, spontaneous rupture, and torsion 3.
- 1. Termos S, Redha A, Zbibo R et al. Torsion of Huge Wandering Accessory Spleen. Case Report and Review of Literature. Int J Surg Case Rep. 2017;38:131-5. doi:10.1016/j.ijscr.2017.07.037 - Pubmed
- 2. Perin A, Cola R, Favretti F. Accessory Wandering Spleen: Report of a Case of Laparoscopic Approach in an Asymptomatic Patient. Int J Surg Case Rep. 2014;5(12):887-9. doi:10.1016/j.ijscr.2014.10.045 - Pubmed
- 3. Vander Maren N & Verbeeck N. The "Jokari Sign", An Imaging Feature Diagnostic of a Wandering Accessory Spleen. J Belg Soc Radiol. 2015;99(1):58-61. doi:10.5334/jbr-btr.857 - Pubmed