Splenosis with Small Bowel Obstruction
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Splenosis with Small Bowel ObstructionA 45-year-old male with a history of significant prior blunt trauma to the abdomen, presents with abdominal pain and nausea. CT of the abdomen (coronal view) shows dilated small bowel loops with decompression of visualised large bowel, consistent with small bowel obstruction. In addition there are multiple scattered soft tissue nodules throughout the peritoneal cavity, which in this clinical context raises the possibility of splenosis and likely the cause of the SBO.
Comment:
The presence of multiple soft tissue nodules in the peritoneal cavity, 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. Bowel obstruction in this case is likely secondary to adhesions from prior trauma.
Ashley Davidoff MD TheCommonVein.net (42226.1) 002SB).