Surgical treatment of liver cirrhosis and hypersplenism with huge accessory spleen – A case report

Abstract Introduction Accessory spleens which are common and separate from the main body of the spleen, are the healthy splenic tissues and usually smaller than 2cm. Here, we report a case of liver cirrhosis and hypersplenism with a huge accessory spleen. This case report and literature review describes the management of the enlarged accessory spleen. Presentation of case We report the case of a 47-year-old man who presented with discomfort in the left upper abdomen and hypodynamia for more than 3 months. The color Doppler sonography and abdominal contrast-enhanced computed tomography (CT) revealed a well-marginated ovoid mass, approximately 13.0 cm × 8.0 cm × 5.0cm between stomach and spleen. The patient underwent the laparoscopic splenectomy because of liver cirrhosis and hypersplenism. The result that the mass is the enlarged accessory spleen was confirmed by pathological diagnosis. Clinical symptoms were relieved in 1 month after operation. Discussion Accessory spleens could enlarge to more than 10cm in patients with liver cirrhosis. CT and laparoscope can be used for preoperative, intraoperative diagnosis of accessory spleens. Laparoscopic splenectomy associated huge accessory splenectomy is one of the effective treatments of patients with liver cirrhosis and hypersplenism. Conclusion Because such a large accessory spleen is rare, to a certain extent, it renders diagnosis more difficult. If we are familiar with its character, unnecessary treatment can be avoided.