Splenic simulation by left hepatic lobe following splenectomy

Area of Science:

• Nuclear medicine
• Radiology
• Abdominal imaging

Background:

• Splenectomy, the surgical removal of the spleen, can lead to significant changes in liver morphology.
• Sulfur colloid scans are commonly used in nuclear medicine to assess spleen and liver function and morphology.

Observation:

• Two cases are presented where liver remodeling post-splenectomy mimicked splenic hypertrophy on sulfur colloid scans.
• In one patient, hepatic scarring was identified as the cause of the simulated splenic image.
• In the second patient, the liver's configuration was attributed to molding within the abdominal cavity.

Findings:

• Post-splenectomy liver remodeling can create appearances that resemble an accessory spleen on sulfur colloid imaging.
• Hepatic scarring and external molding are identified as potential mechanisms for this simulated splenic hypertrophy.
• These findings highlight the importance of considering the patient's surgical history in imaging interpretation.

Implications:

• Clinicians must be aware of potential splenic simulation in the liver of postsplenectomy patients.
• This awareness is particularly important when hypersplenism is suspected.
• Accurate interpretation of nuclear medicine scans in postsplenectomy patients requires consideration of altered hepatic anatomy.