ECTOPIC SPLEEN PRESENTING AS PELVIC MASS
Introduction: Ectopic spleen is a very rare clinical entity, characterized by the absence of one or more of the ligaments, in which the spleen is located outside of its normal position. The spleen can be found anywhere in the abdomen or pelvis owing to its long, vascular pedicle. Ectopic spleens are found more commonly in women. Patients are often asymptomatic and the diagnosis can be accidental. Presentation of case: A female patient at the age of 67 years was undergone on CT investigation after a clinical finding of a suspicious hernia on the anterior abdominal wall. The patient complains of pain in the lower abdomen. A post contrast CT scans clearly reveal of an ectopic spleen in the pelvis with normal enhancement and no signs of infarction or torsion. There was a long splenic pedicle containing tortuous vessels. Discussion: Clinical manifestations of ectopic spleen vary from asymptomatic to complications related to torsion. Imaging findings of the ectopic spleen are the absence of the spleen in its normal position and a mass located anywhere in the abdomen or pelvis with enhancement pattern of a normal splenic tissue. The treatment choice of an ectopic spleen is splenopexy. Splenectomy is required only in case of infarction, which can be diagnosed radiologically. Conclusion: This diagnosis should be considered whenever there are mobile abdominal or pelvic mass, signs, and symptoms of an abdominal discomfort, or an acute abdomen or during investigations of chronic intermittent abdominal pain. CT is the most used methods for diagnosis which revealed the absence of the spleen in its normal position, and a homogeneous mass with contrast enhancement located in the pelvis.
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