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  • • Multiple small implants of splenic tissue disseminated throughout the abdomen following traumatic splenic rupture

    • By themselves, splenic implants are of little clinical significance

    • Multiple small implants of splenic tissue grow in scattered areas on the peritoneal surfaces throughout the abdomen arising from dissemination and autotransplantation of splenic fragments following traumatic rupture of the spleen

    • Usually an incidental finding discovered much later during laparotomy for an unrelated problem

    • Splenic implants are capable of cell culling and some immunologic function

    • The implants stimulate formation of adhesions and may be a cause of intestinal obstruction

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Symptoms and Signs

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  • • Asymptomatic

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Laboratory Findings

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  • • Absence of Howell-Jolly bodies: Characteristic post-splenectomy RBC nuclear remnants that are typically removed by the spleen

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Imaging Findings

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  • CT scan: May be visualized as small peritoneal or mesenteric nodules

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Rule Out

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  • • Splenosis must be distinguished from peritoneal nodules of metastatic carcinoma and from accessory spleens

    • Histologically, they differ from accessory spleens by the absence of elastic or smooth muscle fibers in the delicate capsule

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  • • None needed

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When to Admit

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  • • If complicated by bowel obstruction

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  • • No treatment warranted for uncomplicated splenosis

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Complications

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  • • Bowel obstruction

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Prognosis

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  • • Usually an incidental finding of little significance

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References

Cothren CC et al: Radiographic characteristics of postinjury splenic autotransplantation: avoiding a diagnostic dilemma. J Trauma-Injury Infection & Crit Care 2004;57:537.  [PubMed: 15454799]
Young JT et al: Splenosis: a remote consequence of traumatic splenectomy. J Am Coll Surg 2004;199:500.  [PubMed: 15325622]

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