Tricky Liver Case: Perihepatic Splenosis

Area of Science:

• Medical Imaging
• Abdominal Surgery
• Radiology

Background:

• Splenosis is the autotransplantation of splenic tissue after splenectomy.
• Splenosis can occur in ectopic locations, including the subdiaphragmatic region.
• Ectopic splenic tissue can present as a mass, potentially mimicking other pathologies.

Purpose of the Study:

• To highlight the importance of considering perihepatic splenosis in the differential diagnosis of subdiaphragmatic masses.
• To emphasize the characteristic imaging findings of splenosis that can aid in diagnosis.
• To reduce the incidence of unnecessary interventions for patients with a history of splenectomy.

Main Methods:

• Review of imaging findings in patients with confirmed perihepatic splenosis.
• Correlation of imaging features with clinical history, particularly splenectomy.
• Comparison of imaging characteristics of splenosis with other subdiaphragmatic masses.

Main Results:

• Perihepatic splenosis presents as a subdiaphragmatic mass with enhancement patterns similar to normal splenic tissue on contrast-enhanced imaging.
• Patients with splenosis typically have a history of splenectomy.
• Characteristic imaging findings can help differentiate splenosis from neoplastic or infectious masses.

Conclusions:

• Perihepatic splenosis should be a key consideration in patients with a history of splenectomy presenting with subdiaphragmatic masses.
• Characteristic imaging findings can lead to a non-invasive diagnosis, avoiding further procedures.
• Accurate diagnosis of splenosis prevents unnecessary surgical or percutaneous interventions.