An accessory spleen is a small nodule of splenic tissue found apart from the main body of the spleen. It is also called as supernumerary spleen, splenule, or splenunculus. Present in up to 20% of the population, one or more accessory spleens may also occur in upto 30% of patients with hematologic disease and 10–44% of necropsies. Mostly it is asymptomatic and is found incidentally on Computed Tomography Scan or during other abdominal surgeries. It is symptomatic in few cases where it presents as a lump in abdomen. We present a case of large splenunculi presenting as a lump in abdomen. Patient underwent excision of the cyst with resection and anastomosis of the small bowel segment as it involved its mesentery in its entire breadth. A brief case report with review of literature is presented.

1. Schrtz SI: Spleen, in Schwartz SI (ed): Principles of Surgery: Specific Consider-ations, 7th ed. New York: McGraw-Hill, 1999; 1501.
2. Al Ahmadi M, Brundage S, Brody F, Jacobs L andSakier : Splenosis of the mesoappendix,a case reportand review of literature. Journal of Royal College of Surgery Edinburgh 1998; 43:200-2.
3. Hayward I, Mindelzun RE and Jeffrey RB: Intrapancreatic accessory spleen mimic-king pancreatic masson CT scan. Journal of Computerized Assisted Tomography 1992; 16: 984-5.
4. Servadio Y, Leibovitch I, Aprer S, Mor Y and Goldwasser B: Symptomatic heterotopic splenic tissue inleft renalfossa. European urology. 1994;25: 174-6.
5. Azar GB, Awwad JT and MuffarrijIK :Accessory spleen presenting as adnexal mass. Acta Obstetrica Gynecologica Scandnevica 1993;72:587–8.
6. Raichuk IE, ChesakovSA, NiirchenkoIY, Gerich FN,Kukuriku EV and Bukree VM : Torsion of accessoryspleen Klin Khir. 1994; 10: 64.
7. Fleming CR, Dickson ER and HarrisonEG Splenosis; autotransplantation of splenic tissue. American Journal of Medicine 1976; 61; 414-9.
8. Peddu P, Shah M, Sidhu PS. Splenic abnormalities: a comparative review of ultrasound, microbubble-enhanced ultraso-und and computed tomography. Clin Radiol 2004; 59: 777-92
9. Froehner M, Leike S, Manseck A et al. Splenunculus mimicking late local recurrence of renal cell carcinoma.Scand J Urol Nephrol 1998; 32: 418-9
10. Dawson C, McCormick C, Menai-Willi-ams R et al. Splenunculus masquerading as an adrenal mass. Br J Urol1995; 76: 404-5
11. Ricketts RR. Mesenteric and omental cysts. In: Pediatric Surgery. 5^th 1998:1269-75.

Dr Aman Kumar

GGMC, Mumbai