Torsion of a huge accessory spleen in a 20-year-old patient

INTRODUCTION: Accessory spleen is a rare condition. Torsion of accessory spleen can lead to acute abdomen. PRESENTATION OF CASE: We describe a young woman with an acute abdomen caused by torsion of accessory spleen. Abdominal computed tomography angiography (CTA) demonstrated an ischemic giant accessory spleen with a twisted vascular pedicle. An emergency laparotomy was performed with resection of the infarcted accessory spleen. DISCUSSION: Accessory spleen is a rare and asymptomatic condition. Torsion of accessory spleen is also uncommon. Abdominal pain is the main symptom. CTA is effective in reaching a diagnosis. Definitive treatment of an acute abdomen due to accessory splenic torsion is emergency accessory splenectomy. CONCLUSION: Elective accessory splenectomy should be recommended for known giant accessory spleen to prevent complications in future. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of Surgical Associates Ltd. Open access under CC BY-NC-ND license.