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Case Reports
. 2021 Apr 18;16(6):1543-1547.
doi: 10.1016/j.radcr.2021.03.055. eCollection 2021 Jun.

Perirectal intraperitoneal splenosis: A case report of MRI with laparoscopic correlation

Sandra Raab  1 , Georg Hagleitner  2 , Reinhard Motz  3 , Franz A Fellner  2   4 , Andreas Shamiyeh  1
Affiliations
Case Reports

Perirectal intraperitoneal splenosis: A case report of MRI with laparoscopic correlation

Sandra Raab et al. Radiol Case Rep. .

Abstract

Splenosis is a benign acquired condition, which appears after rupture of the spleen and heterotopic auto-transplantation. Mostly found as an incidental finding on cross-sectional imaging, definitive diagnosis is frequently made histologically after resection or tissue sampling. We report a case of a 36-year-old male patient who presented with increased susceptibility to infections, chronic fatigue, and a history of traumatic splenic rupture. Cross-sectional imaging showed perirectal formations within the mesorectal fascia, and extraperitoneal splenosis was suspected. Due to the radiologically unclear entity of the masses, diagnostic laparoscopy with tissue sampling was performed. Intraoperatively the masses turned out to be intraperitoneal. Histological workup showed splenic tissue, consistent with intraperitoneal splenosis after splenic rupture. In this article we want to discuss important imaging findings and their differentials, as well as clinical implications for this rare entity.

Keywords: Incidentaloma; Intraperitoneal Splenosis; Laparoscopy; MRI; Splenectomy; Trauma.

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Figures

Fig 1:
Fig. 1
Axial contrast-enhanced CT image showed nodular perirectal masses (arrow).
Fig 2:
Fig. 2
Transverse MR imaging demonstrates multiple nodular perirectal formations (arrow) with intermediate signal on plain images and homogeneous enhancement after i.v. administration of gadolinium: (A) T2-weighted and (B) T1-weighted image before as well as (C) T1-weighted without and (D) T1-weighted image with fat saturation after gadolinium administration.
Fig 3:
Fig. 3
Sagittal T2-weighted MR image shows the nodular formations adjacent to the rectum.
Figure 4:
Figure 4
Histopathological workup from the resected specimen, hematoxylin and eosin staining finally revealed normal splenic tissue.
See this image and copyright information in PMC

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