[Skip to Content]
[Skip to Content Landing]
Article
June 1969

Increased Incidence of Accessory Spleens in Hematologic Disease

Author Affiliations

Ann Arbor, Mich
From the Department of Surgery, University of Michigan Medical Center, and the Ann Arbor Veterans Administration Hospital, Ann Arbor, Mich.

Arch Surg. 1969;98(6):762-763. doi:10.1001/archsurg.1969.01340120110019
Abstract

Despite their small size, accessory spleens are clinically important. Hematologists have long emphasized their occasional role in the reexacerbation of hematologic disease after initially beneficial splenectomy.1-7 Accessory spleens have been known to rupture,8 twist on their pedicles and strangulate,5,6,9 cause bowel obstruction,10 and produce defects on upper gastrointestinal radiographs suggestive of gastric neoplasms.11,12 Although accessory spleens are well recognized as a cause of disease, there is little published evidence to suggest that their apparent frequency may be the result of disease.

Anatomy textbooks tend to mention the infrequent presence of accessory spleens as an anatomic fact devoid of pathological significance. Settle states, "the accessory spleen is an anomaly [which is the] result of a development abnormality in the embryo."6 Downey13 and Arey14 share this belief. To some degree this is true, as substantiated by the occasional presence of accessory spleens in normal

References
1.
Curtis, G.M., and Movitz, D.:  The Surgical Significance of the Accessory Spleen ,  Ann Surg 123:276-298 ( (Feb) ) 1946.Crossref
2.
Doan, CA.:  Hypersplenism ,  Bull NY Acad Med 25:625-650 ( (Oct) ) 1949.
3.
Evans, T.S., et al:  Recurrent Hypersplenism Due to Accessory Spleen ,  Ada Haemat 10:350-359 ( (Dec) ) 1953.
4.
Morrison, M.; Lederer, M.; and Fradkin, W.Z.:  Accessory Spleens: Their Significance in Essential Thrombocytopenic Purpura Hemorrhagica ,  Amer J Med Sci 176:672-681 ( (Nov) ) 1928.Crossref
5.
Rosenthal, N., et al:  The Role of Accessory Spleens in Post-splenectomy Recurrent Purpura Hemorrhagica ,  J Mount Sinai Hosp NY 17:1008-1020 ( (March) -April) 1950-1951.
6.
Settle, E.B.:  The Surgical Importance of Accessory Spleens ,  Amer J Surg 50:22-26 ( (Oct) ) 1940.Crossref
7.
Thorek, P.; Gradman, R.; and Welch, J.S.:  Recurrent Primary Thrombocytopenic Purpura With Accessory Spleens: Review of the Literature ,  Ann Surg 128:304-311 ( (Aug) ) 1948.Crossref
8.
Kumar, R.:  A Case of Traumatic Rupture of an Accessory Spleen ,  Arch Dis Child 37:227 ( (April) ) 1962.Crossref
9.
Bass, R.T.; Yao, S.T.; and Freeark, R.J.:  Torsion of an Accessory Spleen of The Cecum Presenting an Acute Appendicitis ,  New Eng J Med 277:1190-1191 ( (Nov 30) ) 1967.Crossref
10.
Voss, P.:  Accessory Spleen Associated With Chronic Intestinal Obstruction ,  Aust New Zeal J Surg 3:287-288 ( (Jan) ) 1934.Crossref
11.
Brown, R.B., and Dobbie, R.P., Jr.:  Splenic Indentation of the Gastric Fundus Resembling Gastric Neoplasm: Report of Two Cases ,  Amer J Roentgen 81:599-602 ( (April) ) 1959.
12.
Das Gupta, T.K., and Busch, R.C.:  Accessory Splenic Tissue Producing Indentation of the Gastric Fundus Resembling Gastric Neoplasm ,  New Eng J Med 263:1360-1361 ( (Dec 29) ) 1960.Crossref
13.
Downey, H.:  Handbook of Hematology , New York: Paul B. Hoeber Inc, Medical Bk. Dept. of Harper & Row, 1938, vol 3, p 1677.
14.
Arey, L.B.:  Developmental Anatomy: A Textbook and Laboratory Manual of Embryology , ed 6, Philadelphia and London: W. B. Saunders Co., 1954, pp 392-393.
15.
Elliott, R.H.E., Jr., and Turner, J.C.:  Splenectomy for Purpura Hemorrhagica ,  Surg Gynec Obstet 92:539-544 ( (May) ) 1951.
16.
Halpert, B., and Györkey, F.:  Lesions Observed in Accessory Spleens of 311 Patients ,  Amer J Clin Path 32:165-168 ( (Aug) ) 1959.
17.
Schilling, K.:  Uber einen Fall von multiplen Nebenmilzen ,  Virchow Arch Path Anat 188:65-87 ( (April) ) 1907.Crossref
18.
Bennett-Jones, M.J., and St. Hill, C.A.:  Accessory Spleen in the Scrotum ,  Brit J Surg 40:259-262 ( (Nov) ) 1952.Crossref
19.
Grossman, S.L.; Goldberg, M.M.; and Hermann, H.B.:  A Case Report of Ectopic Splenic Tissue in the Scrotum ,  J Urol 81:294-296 ( (Feb) ) 1959.
20.
Sneath, W.A.:  An Apparent Third Testicle Consisting of a Scrotal Spleen ,  J Anat and Physiol 47:340-342 ( (April) ) 1912-1913.
21.
Paul, M.:  Accessory Spleens ,  Lancet 2:74-76 ( (July 10) ) 1937.Crossref
22.
Adami, J.G., and Nichols, A.G.:  Principles of Pathology , Philadelphia and New York: Lea and Febiger, 1909, vol 2, p 222.
23.
Block, G.E.; Evans, R.; and Zajtchuk, R.:  Splenectomy for Idiopathic Thrombocytopenia Purpura ,  Arch Surg 92:484-489 ( (April) ) 1966.Crossref
24.
Dameshek, W., and Welch, C.S.:  Hypersplenism and Surgery of the Spleen , New York: Grune and Stratton, Inc., 1953, p 69.
25.
Eccles, W.M., and Freer, G.D.:  Enlargement of a Splenculus to the Size of a Normal Spleen ,  Brit Med J 2:515 ( (Oct 1) ) 1921.Crossref
×