Non-traumatic torsion of an accessory spleen as a cause of acute abdomen in adults

Introduction
An accessory spleen (AS) is a congenital anomaly characterized by nodules of splenic tissue separate from the primary spleen, with a prevalence of 10% to 30%. Complications include torsion, infarction, cysts, and bleeding. Occasionally, AS can migrate within the abdomen, causing pain by pressing on internal organs. Torsion of AS is rare but serious, often leading to acute abdomen symptoms that may require surgical intervention.

Aim of the research
This study investigates the clinical symptoms of AS torsion and the circumstances that necessitate surgical intervention. The professional literature on AS symptoms consists only of case reports, prompting the authors to conduct a broader analysis of this condition.

Material and methods
The analysis included 24 cases of non-traumatic AS torsion in adults published between 2001 and 2024, focusing only on complete cases following the introduction of laparoscopic diagnostics. The desk research method and statistical analysis were used to assess the outcome.

Results
A total of 24 cases were identified, comprising 16 women and 8 men, aged 19 to 47 years, with a mean age of 27.1 years; half were under 24.5 years old. Abdominal pain was the most common symptom. A correct preoperative diagnosis of AS torsion was made in 8 cases. Surgical interventions included laparotomy (15 cases) and laparoscopy (9 cases), with no reported mortality.

Conclusions
AS torsion symptoms are often nonspecific, complicating diagnosis. Early recognition and surgical intervention are crucial for treatment outcomes. AS torsion should be included in differential diagnoses for the acute abdomen of unknown aetiology, particularly in young adults.