Spontaneous Rupture of Accessory Spleen Detected during Laparoscopic Cholecystectomy

Splenic rupture during laparoscopic cholecystectomy is a rare and unusual complication. We report a case of accessory splenic rupture that occurred during laparoscopic cholecystectomy. A 63-year-old male patient underwent laparoscopic cholecystectomy due to acute cholecystitis. After pneumoperitoneum was established, hemoperitoneum was detected. However, a bleeding focus was not found by laparoscopic whole abdominal exploration after laparoscopic cholecystectomy. Twenty-four hours later the patient became hypotensive and laparoscopic reexploration was performed. Hematoma and omental adhesion was detected around accessory spleen. Laparoscopic accessory splenectomy was performed. Distortion or stretching of perisplenic adhesion due to the induction of pneumoperitoneum possibly resulted in sudden splenic rupture and hemoperitoneum. U Korean Surg Soc 2009;76:326-328)