Splenosis: A Rare Etiology for Bowel Obstruction-A Case Report and Review of the Literature

Abstract

Splenosis is a historically uncommon etiology for bowel obstruction. Autotransplanted splenic tissues following surgery or trauma of the spleen are known to occur in multiple locations of the abdominal cavity and pelvis. The small bowel mesentery is a blood vessel-rich environment for growth of splenic fragments. We present a case of a 36-year-old male patient who sustained a gunshot wound to his left abdomen requiring a splenectomy and bowel resection fifteen years prior to his presentation with small bowel obstruction requiring exploration, adhesiolysis, and resection of the mesenteric splenic deposit. Our aim in this report is to provide awareness of splenosis as an etiology for bowel obstruction, especially with increased incidence and survival following abdominal traumas requiring splenectomies. We also stress on the importance of history and physical examination to include splenosis on the list of differential diagnoses for bowel obstruction.

Figure 1

Abdominal X-ray shown in (a), depicting the number of shrapnel left in the left side of the body after the gunshot injury, in addition to dilated loops of bowel. CT scan with oral and intravenous contrast shows the splenosis deposit (white arrow) in axial (b) and coronal (c) views.

Figure 2

H&E stained slides of the splenosis deposit showing splenosis architecture. Splenic nodules separated by strands of fibrous trabeculae (a). White and red pulp nodules are seen (b).