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 (coronal view) shows dilated small bowel loops (b orange asterisk) with decompressed colon (b light brown arrowheads) , consistent with small bowel obstruction, and multiple scattered soft tissue nodules throughout the peritoneal cavity, (b red arrowheads)  consistent with 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 (42226.1cL, 002SB).