Unveiling three accessory spleens in one patient: a rare case report and literature review
Abstract Background During embryogenesis, the spleen undergoes intricate developmental processes, originating from mesenchymal cells in the dorsal mesentery. An accessory spleen, a common anomaly found in autopsies and abdominal CT scans, can often be mistaken for different types of tumors. To the b...
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BMC
2024-11-01
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| Series: | International Journal of Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s12245-024-00758-3 |
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| author | Hamdah Hanifa Hussein Alhussein Lissa Mahmandar Sara Kadi Mahfoud Najjar Ahmad Alhaj |
| author_facet | Hamdah Hanifa Hussein Alhussein Lissa Mahmandar Sara Kadi Mahfoud Najjar Ahmad Alhaj |
| author_sort | Hamdah Hanifa |
| collection | DOAJ |
| description | Abstract Background During embryogenesis, the spleen undergoes intricate developmental processes, originating from mesenchymal cells in the dorsal mesentery. An accessory spleen, a common anomaly found in autopsies and abdominal CT scans, can often be mistaken for different types of tumors. To the best of our knowledge, this is the first case in Syria documenting the occurrence of 3 accessory spleens in a patient who had previously undergone splenectomy. Case presentation A 33-year-old male presented with right hypochondrium pain, sharp and radiating to the right flank, exacerbated by movement and large meals. Past medical history included mild Irritable Bowel Syndrome (IBS) and splenectomy due to a traumatic accident in childhood. On admission, vital signs were stable, with abdominal tenderness in the right upper quadrant. Laboratory investigations showed normal values. Ultrasound revealed a lobulated mass at the right adrenal gland (4.5 × 5 cm) with an isoechoic to hypoechoic texture. Multi-slice computed tomography (MSCT) Scan showed multiple nodules in the right adrenal gland, regular in shape, exerting a compressive mass effect, and significant lymphadenopathy around the abdominal aorta. Elevated metanephrine levels raised suspicion of an extra-adrenal pheochromocytoma. Laparoscopic surgery was performed, revealing accessory spleens and normal adrenal tissue with no malignancy. Conclusion Healthcare providers should consider accessory spleens as a differential diagnosis for masses near the adrenal glands. Multiple accessory spleens in the adrenal region can complicate cases. Accessory spleens in uncommon locations like the adrenal glands can be challenging to diagnose and manage. |
| format | Article |
| id | doaj-art-015aeacd0a5e4396a80c6cfdb4324f55 |
| institution | Kabale University |
| issn | 1865-1380 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Emergency Medicine |
| spelling | doaj-art-015aeacd0a5e4396a80c6cfdb4324f552024-12-01T12:08:24ZengBMCInternational Journal of Emergency Medicine1865-13802024-11-011711610.1186/s12245-024-00758-3Unveiling three accessory spleens in one patient: a rare case report and literature reviewHamdah Hanifa0Hussein Alhussein1Lissa Mahmandar2Sara Kadi3Mahfoud Najjar4Ahmad Alhaj5Faculty of Medicine, University of KalamoonFaculty of Medicine, University of AleppoFaculty of Medicine, University of AleppoFaculty of Medicine, University of AleppoDepartment of Surgery, General Surgery Division, Aleppo University HospitalDepartment of Surgery, Faculty of Medicine, University of AleppoAbstract Background During embryogenesis, the spleen undergoes intricate developmental processes, originating from mesenchymal cells in the dorsal mesentery. An accessory spleen, a common anomaly found in autopsies and abdominal CT scans, can often be mistaken for different types of tumors. To the best of our knowledge, this is the first case in Syria documenting the occurrence of 3 accessory spleens in a patient who had previously undergone splenectomy. Case presentation A 33-year-old male presented with right hypochondrium pain, sharp and radiating to the right flank, exacerbated by movement and large meals. Past medical history included mild Irritable Bowel Syndrome (IBS) and splenectomy due to a traumatic accident in childhood. On admission, vital signs were stable, with abdominal tenderness in the right upper quadrant. Laboratory investigations showed normal values. Ultrasound revealed a lobulated mass at the right adrenal gland (4.5 × 5 cm) with an isoechoic to hypoechoic texture. Multi-slice computed tomography (MSCT) Scan showed multiple nodules in the right adrenal gland, regular in shape, exerting a compressive mass effect, and significant lymphadenopathy around the abdominal aorta. Elevated metanephrine levels raised suspicion of an extra-adrenal pheochromocytoma. Laparoscopic surgery was performed, revealing accessory spleens and normal adrenal tissue with no malignancy. Conclusion Healthcare providers should consider accessory spleens as a differential diagnosis for masses near the adrenal glands. Multiple accessory spleens in the adrenal region can complicate cases. Accessory spleens in uncommon locations like the adrenal glands can be challenging to diagnose and manage.https://doi.org/10.1186/s12245-024-00758-3Accessory spleenCase reportMisdiagnosisSplenosisPheochromocytomaAdrenal tumour |
| spellingShingle | Hamdah Hanifa Hussein Alhussein Lissa Mahmandar Sara Kadi Mahfoud Najjar Ahmad Alhaj Unveiling three accessory spleens in one patient: a rare case report and literature review International Journal of Emergency Medicine Accessory spleen Case report Misdiagnosis Splenosis Pheochromocytoma Adrenal tumour |
| title | Unveiling three accessory spleens in one patient: a rare case report and literature review |
| title_full | Unveiling three accessory spleens in one patient: a rare case report and literature review |
| title_fullStr | Unveiling three accessory spleens in one patient: a rare case report and literature review |
| title_full_unstemmed | Unveiling three accessory spleens in one patient: a rare case report and literature review |
| title_short | Unveiling three accessory spleens in one patient: a rare case report and literature review |
| title_sort | unveiling three accessory spleens in one patient a rare case report and literature review |
| topic | Accessory spleen Case report Misdiagnosis Splenosis Pheochromocytoma Adrenal tumour |
| url | https://doi.org/10.1186/s12245-024-00758-3 |
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