Splenosis with Small Bowel Obstruction

A 45-year-old male with a history of prior trauma presents with abdominal pain and nausea. CT of the abdomen (a, coronal view; b, c, d, axial views through mid and lower abdomen) shows dilated small bowel loops with contrast-filled cecum and transverse colon, a decompressed descending colon, and multiple scattered soft tissue nodules throughout the peritoneal cavity, consistent with splenosis and likely the cause of partial small bowel obstruction (SBO).

Comment: The presence of multiple soft tissue nodules in the peritoneal cavity, (in the context of prior trauma and absent spleen) is consistent with splenosis, results from splenic tissue seeding following trauma or splenectomy. These nodules are often functional and can mimic peritoneal carcinomatosis but should be differentiated based on imaging and clinical history. Tc-99m sulfur colloid scans can confirm the presence of splenic tissue. Partial bowel obstruction in this case is likely secondary to adhesions from prior trauma.

Ashley Davidoff MD TheCommonVein.net (42228c06b, 002SB).