Unusual case of an ectopic spleen

A rare case of a very unusual position of a normally functioning spleen in the posterior aspect of the right lobe of the liver is reported. A 6-year-old boy was evaluated with echocardiography for congenital heart disease of coexisting atrial and ventricular septal defects with pulmonary hypertension. Other associated cardiac abnormalities on this child included a right-sided aortic arch, drainage of the azygous vein into the superior vena cava and an Eisenmenger complex. At the time of echocardiography, absence of the spleen in its normal location was noted. This prompted further investigation into localizing the spleen using 99mTc-sulfur colloid and heat denatured 99mTc-RBC scintigraphy. Both scans demonstrated the spleen to lie posterior to the right hepatic lobe.