A CASE OF PORTAL HYPERTENSION ASSOCIATED WITH LARGE ACCESSORY SPLEEN AFTER SPLENECTOMY

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A 45-year-old male with a previous splenectomy has admitted to our hospital because of acute gastrointestinal bleeding. He was found endoscopically to have a benign gastric ulcer as the cause of the bleeding and esophagogastric varices. His laboratory findings were suggestive of liver cirrhosis. In order to evaluate the liver cirrhosis, computed tomography of the abdomen revealed a 6-cm spherical mass in the left upper quadrant. Technetium 99m-colloidal liver-spleen scan, ultrasonic scan of the abdomen, and celiac angiography were subsequently done and the unexplained abdominal mass demonstrated on CT examination was considered to be an enlarged accessory spleen. This accessory spleen was removed and was histologically confirmed at the subsequent microscopic examination. It was 6 cm in diameter, 130 g in weight and one of the largest accessory spleens that have ever reported. This case demostrated the usefulness of these diagnostic imaging methods to identify the residual accessory splenic tissue and suggested the necessity of search for accessory splenic tissue at the time of initial splenectomy.
社団法人日本消化器内視鏡学会の論文