False-positive spleen imaging. Splenic cleft and accessory spleen

Area of Science:

• Medical Imaging
• Radiology
• Surgical Pathology

Background:

• Trauma patients may present with falling hematocrit, necessitating imaging to assess for internal injuries.
• Splenic injuries are a common concern following blunt abdominal trauma.

Observation:

• A 35-year-old male patient exhibited a falling hematocrit post-trauma.
• Radiocolloid imaging revealed a superior pole splenic defect with a bilobed appearance, suggesting a trans-section.
• A small functional area was noted below the main spleen, and a small accessory spleen was present inferiorly.

Findings:

• Surgical exploration identified marked splenic lobulation, potentially congenital, explaining the imaging findings.
• The accessory spleen mimicked a disrupted splenic segment, contributing to the false-positive imaging interpretation.
• This case highlights the rarity of false-positive radiocolloid imaging results in trauma assessment.

Implications:

• Radiocolloid imaging findings suggestive of splenic trauma should be critically evaluated in light of potential congenital anomalies.
• Understanding splenic variants is crucial for accurate interpretation of imaging studies in trauma patients.
• This case underscores the importance of correlating imaging with surgical findings to avoid misdiagnosis.