PMC4900206_01
22 year old female with torsion of accessory spleen. CT of the abdomen and pelvis for trauma 7 months before the current hospital admission. Axial (A) and coronal (B) reformatted CT demonstrates a normal spleen in the left upper quadrant (S) with two normal accessory spleens (*) located medial and anterior to the inferior splenic pole. The smaller measures 0.9 cm, and the larger measures 1.9 x 1.9 cm (transverse) x 2.7 cm (height). The vascular pedicle supplying the larger of the two accessory spleens arises from the splenic artery and is well seen on the coronal reformatted CT (arrow).
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On the earlier CT, two small accessory spleens enhanced normally (Fig. 1).
22 year old female with torsion of accessory spleen. Axial (A and B) and coronal (C) reformatted CT taken at the time of current admission demonstrates torsion of the larger of two accessory spleens (*). This accessory spleen has grown, now measuring 2.7 x 3.4 cm (transverse) x 2.6 cm (height). It has also rotated such that now it is wider than tall. It has shifted position and is now situated inferior to the spleen (S) and the other, smaller, accessory spleen. It demonstrates diminished enhancement with edema in the surrounding fat due to venous congestion secondary to torsion of the vascular pedicle. The torsed vascular pedicle is identified on the axial and coronal reformatted scans (arrow). There is intense enhancement of the capsule due to patent capsular arteries.
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On the current CT, the larger of the two accessory spleens had enlarged and demonstrated diminished enhancement, with edema in the surrounding fat (Fig. 2).