Chronic Abdominal Pain from Disseminated Splenosis
KEY WORDSclinical image abdominal mass disseminated splenosis nuclear scintigraphy
Disseminated splenosis (DS) is a benign condition caused by metastatic deposits of splenic tissue following trauma or surgery. DS is usually asymptomatic and diagnosed incidentally by ultrasound or computed tomography, but can cause site-specific discomfort mimicking endometriosis or peritoneal metastases.1 Other reported complications include gastrointestinal bleeding, bowel obstruction, and hydronephrosis.2 Nuclear scintigraphy with Tc99m-dRBC localizes ectopic splenic tissue based on the increased uptake of damaged erythrocytes within the reticuloendothelial system.3, 4 In the setting of previous splenic trauma, this noninvasive technique is a sensitive and specific tool to establish the diagnosis, potentially avoiding invasive tissue sampling or diagnostic laparoscopy.5 Patients with DS may retain partial immunoprotection from encapsulated organisms,6 but no studies have shown an optimal approach to assessing residual splenic function.7
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Conflict of Interest
The author declares that he does not have a conflict of interest.