Yoshida Miki, Saida Tsukasa, Masuoka Souta, Urushibara Aiko, Chiba Fumiko, Masumoto Kouji
Department of Radiology, University of Tsukuba Hospital, Tsukuba, Japan.
Department of Radiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
J Med Ultrasound. 2021 Jun 21;29(2):116-118. doi: 10.4103/JMU.JMU_35_20. eCollection 2021 Apr-Jun.
We report a case of a 12-year-old boy with an accessory spleen torsion. He presented with left-sided abdominal pain after trauma. A 4 cm oval mass without contrast enhancement was detected on contrast-enhanced computed tomography (CT), and ultrasound (US) showed a 4 cm oval mass below the spleen. The mass mainly consisted of high echoes similar to the spleen; the central part showed irregularly low echoes. Subsequent follow-up daily US examinations showed gradual expansion of the central low echoes with conspicuous hyperechoic dots. Discontinuation of the branch from the splenic artery to the mass was observed, both, on US and CT. These findings led to the diagnosis of a hemorrhagic infarct caused by torsion of the accessory spleen. Laparoscopy showed adherence of the accessory spleen to the omentum and colon by twisting four times around its axis. It was resected and confirmed the diagnosis of a torsioned accessory spleen.
我们报告一例12岁男孩发生副脾扭转的病例。他在创伤后出现左侧腹痛。增强计算机断层扫描（CT）检查发现一个4厘米的椭圆形无强化肿块，超声（US）显示脾脏下方有一个4厘米的椭圆形肿块。该肿块主要由与脾脏相似的高回声组成；中心部分呈不规则低回声。随后每日超声随访检查显示中心低回声逐渐扩大，伴有明显的高回声点。超声和CT均观察到脾动脉至肿块的分支中断。这些发现导致诊断为副脾扭转引起的出血性梗死。腹腔镜检查显示副脾通过围绕其轴扭转四次而与大网膜和结肠粘连。将其切除，证实为扭转的副脾。
