Most Common Site for Accessory Splenic Tissue
The most common site for accessory splenic tissue is the splenic hilum (option c). 1, 2, 3, 4
Anatomical Distribution of Accessory Spleens
Accessory spleens (splenules) are found in approximately 10-30% of the general population 1. The distribution of accessory splenic tissue follows a clear pattern:
- Splenic hilum: 75% of accessory spleens are located at the splenic hilum 2
- Pancreatic tail region: Almost 20% of accessory spleens are found in or near the pancreatic tail 3
- Other locations: Less commonly found in the:
- Gastrosplenic ligament
- Splenocolic ligament
- Greater omentum
- Pelvis (extremely rare) 4
Clinical Significance
Understanding the location of accessory splenic tissue is important for several clinical scenarios:
Post-splenectomy recurrence of hematologic disease: Missed accessory spleens can cause recurrence of conditions like idiopathic thrombocytopenic purpura after splenectomy 2, 5
Diagnostic challenges: Accessory spleens can mimic:
Surgical considerations: During splenectomy for hematologic disorders, identification and removal of accessory spleens is critical to prevent disease recurrence 2
Detection Methods
- Laparoscopic exploration: Superior sensitivity (100%) for detecting accessory spleens compared to preoperative imaging 2
- CT/MRI: Sensitivity of 90-95% for detecting splenules, but may miss smaller accessory spleens 1
- Nuclear medicine scans: Particularly useful for confirming suspected accessory splenic tissue 6
Key Points to Remember
- Accessory spleens are common anatomical variants
- The splenic hilum is by far the most common location
- They are typically asymptomatic but can become clinically significant after splenectomy
- Imaging studies may misidentify accessory spleens as tumors or miss them entirely
- Direct visualization during surgery remains the gold standard for identification