- Additional spleens in children. Literature review and own clinical observations
Additional spleens in children. Literature review and own clinical observations
Paediatric Surgery (Ukraine). 2025. 2(87): 94-102. doi: 10.15574/PS.2025.2(87).94102
Rybalchenko V. F.1,2, Kozachuk V. G.1,2, Gorelik V. V.1,2, Taranenko T. V.1,2, Adamchuk S. F.2
1Shupyk National University of Healthcare of Ukraine, Kyiv
2KNP "Kyiv City Children's Clinical Hospital No. 1", Ukraine
For citation: Rybalchenko VF, Kozachuk VG, Gorelik VV, Taranenko TV, Adamchuk SF. (2025). ditional spleens in children. Literature review and own clinical observations. Paediatric Surgery (Ukraine). 2(87): 94-102. doi: 10.15574/PS.2025.2(87).94102.
Article received: Mar 26, 2025. Accepted for publication: Jun 10, 2025.
Aim – to conduct a literature review analysis on accessory spleens in children and to establish the prevalence, number and localization, as well as modern visualization methods, features of the course and significant indications for surgical treatment.
Accessory spleens account for 10% to 30% of the population. The prevalence of additional spleens was established, which varied depending on the imaging method: verification using ultrasound, computer tomography, magnetic resonance imaging took place from 16.6% to 30.1%, intraoperative from 14.3% to 14.6%, and cadaveric from 0.6% to 9.1%. By the number of additional spleens, it was established that one additional spleen took place from 21.4% to 85%, and two or more from 25.0% to 64.3%. Additional spleens were localized in the splenic hilum from 41.7% to 75%, in lig.gastrolienale 15.0% to 54.0%. Surgical treatment – removal of the additional spleen is indicated only if it is complicated by volvulus, necrosis and suppuration, and isolated cases are described as clinical observations. There were 195 patients with additional spleens for 30 years, aged from 3 months to 18 years, of which 103 (52.82%) were male, 92 (47.18%) were female. Patients were divided into two groups: the first group 59 (30.26%) – inpatient surgical treatment of other ailments, the second group – 136 (69.74%), who were treated on an outpatient basis.
Conclusions. An additional spleen is a congenital anomaly that is usually asymptomatic, but can clinically manifest complications such as torsion, spontaneous rupture with bleeding, suppuration and cyst formation, which requires urgent examination and treatment, including surgical removal of the twisted additional spleen.
The authors declare no conflict of interest.
Keywords: developmental malformations, additional spleen, diagnostics, tactics, treatment.
REFERENCES
1. Abdullin RF, Kondratenko EG, Koshyk EA, Ivanov DV. (2014). The morphological characteristic of intrapancreatic accesory spleen at newborns and children of the first year of life. Sovremennaya Pediatriya. 2(58): 95-100. doi: 10.15574/SP.2014.58.95.
2. Alexander RC, Romanes A. (1914). Accessory spleen causing acute attacks of abdominal pain. Lancet. 184: 1089-1091. https://doi.org/10.1016/S0140-6736(00)96489-4
3. Bajwa SA, Kasi A. (2025, Jan). Anatomy, Abdomen, and Pelvis: Accessory Spleen. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. URL: https://www.ncbi.nlm.nih.gov/books/NBK519040/?utm_medium=email&utm_source=transaction.
4. Bezrodnyi BH, Kolosovych IV, Hanol IV. (2014). Khirurhichne likuvannia zakhvoriuvan selezinky. Kyiv: Valrus Dyzain: 208. ISBN: 978-966-1562-08-9.
5. Di Serafino M, Verde F, Ferro F, Vezzali N, Rossi E, Acampora C et al. (2019, Dec). Ultrasonography of the pediatric spleen: a pictorial essay. J Ultrasound. 22(4): 503-512. https://doi.org/10.1007/s40477-018-0341-2; PMid:30446947 PMCid:PMC6838283
6. Gill N, Nasir A, Douglin J, Pretterklieber B, Steinke H et al. (2017). Accessory Spleen in the Greater Omentum: Embryology and Revisited Prevalence Rates. Cells Tissues Organs. 203(6): 374-378. Epub 2017 Apr 19. https://doi.org/10.1159/000458754; PMid:28420007
7. Matthew C, Rajendran R R (2023, May 18). Accessory Spleen Mimicking an Intrahepatic Neoplasm: A Rare Case Report. Cureus. 15(5): e39185. https://doi.org/10.7759/cureus.39185
8. Mayer A, Varga I, Kachlik D, Voller J, Fuljer I, Jackuliak P. (2025). Accessory Spleen: An Anatomical Variation or Developmental Defect? Surgical, Anatomical and Embryological Perspectives. Bratisl. Med. J. 126: 6-13 https://doi.org/10.1007/s44411-025-00042-7
9. Ren C, Liu Y, Cao R, Zhao T, Chen D et al. (2017, Sep). Colonic obstruction caused by accessory spleen torsion: A rare case report and literature review. Medicine (Baltimore). 96(39): e8116. https://doi.org/10.1097/MD.0000000000008116; PMid:28953636 PMCid:PMC5626279
10. Romer T, Wiesner W. (2012, Mar-Apr). The accessory spleen: prevalence and imaging findings in 1,735 consecutive patients examined by multidetector computed tomography. JBR-BTR. 95(2): 61-65. PMID: 22764656. https://doi.org/10.5334/jbr-btr.75
11. Rybalchenko VF, Urin OM, Brahynska SA, Mamontov DS, Rinzberh BS, Rozshchepii SO et al. (2019). Dodatkovi selezinky u ditei. Zbirnyk naukovykh prats za meterialamy naukovo-praktychnoi konferentsii 18-19 zhovtnia 2019 roku «Innovatsiini tekhnolohii v khirurhii ta anesteziolohii i intensyvnii terapii dytiachoho viku». m. Kyiv: 42-43.
12. Sadler TW. (2018). Langman's medical embryology. Lippincott Williams & Wilkins.
13. Scirè G, Zampieri N, El-Dalati G, Camoglio FS. (2013). Conservative management of accessory spleen torsion in children. Minerva Pediatrica. 65(4): 453-456.
14. Simon DA, Fleishman NR, Choi P, Fraser JD, Fischer RT. (2020, May 4). Torsion of an Accessory Spleen in a Child with Biliary Atresia Splenic Malformation Syndrome. Front Pediatr. 8: 220. https://doi.org/10.3389/fped.2020.00220; PMid:32432066 PMCid:PMC7212802
15. Trinci M, Ianniello S, Galluzzo M, Giangregorio C, Palliola R, Briganti V et al. (2019, Mar). A rare case of accessory spleen torsion in a child diagnosed by ultrasound (US) and contrast-enhanced ultrasound (CEUS). J Ultrasound. 22(1): 99-102. Epub 2019 Feb 13. https://doi.org/10.1007/s40477-019-00359-4; PMid:30758809 PMCid:PMC6430300
16. Vikse J, Sanna B, Henry BM, Taterra D, Sanna S, Pękala PA et al. (2017, Sep). The prevalence and morphometry of an accessory spleen: A meta-analysis and systematic review of 22,487 patients. Int J Surg. 45: 18-28. Epub 2017 Jul 15. https://doi.org/10.1016/j.ijsu.2017.07.045; PMid:28716661
17. Yildiz AE, Ariyurek MO, Karcaaltincaba M. (2013, Apr 21). Splenic anomalies of shape, size, and location: pictorial essay. ScientificWorldJournal. 2013: 321810. https://doi.org/10.1155/2013/321810; PMid:23710135 PMCid:PMC3654276