Congenital and anatomical conditions of the spleen

Conditions in this group

This group includes wandering spleen, torsion of a wandering spleen, accessory spleen, splenogonadal fusion, and splenosis.

How they develop and how they are diagnosed

A wandering spleen results from laxity or absence of the ligaments that hold it in place. It may move within the abdomen or pelvis and twist around its vascular pedicle. Torsion can lead to acute pain and infarction. An accessory spleen is a small additional focus of splenic tissue and is particularly important when splenectomy is performed for a hematological condition. Splenosis is implantation of splenic tissue after trauma or previous splenectomy.

CT or MRI shows the position of the spleen, its blood supply, and the presence of accessory splenic tissue. In acute torsion, diagnosis is urgent.

Treatment

For a wandering but viable spleen, splenopexy, meaning surgical fixation of the organ, may be performed. When there is infarction or a nonviable spleen, splenectomy may be needed. An accessory spleen or splenosis usually needs no treatment unless it is associated with persistence of a hematological disease, symptoms, or diagnostic uncertainty.

Frequently asked questions

Is wandering spleen an emergency?

Acute pain may indicate torsion and requires immediate assessment.

Why is an accessory spleen sought before splenectomy?

In some hematological conditions, remaining functioning accessory tissue may limit the expected therapeutic effect.

Is splenosis cancer?

No. It is a benign implantation of splenic tissue, but can sometimes mimic other lesions on imaging.