Splenectomy after splenic two-time break in patient with accessory spleen: Case report

Goal. Report a case of splenectomy in trauma with splenic rupture in two stages due to a patient with an accessory spleen together with a discussion of the literature on the subject. Method. Descriptive study in a general surgery service. In order to foster discussion on the topic, an integrative literature review was carried out based on the collection of scientific articles in the MEDLINE (via PubMed) and SciELO databases. Results. Grade III injury initially has no surgical indication. However, the history of trauma, clinical suspicion and classic symptoms of two-stage rupture of the spleen lead to surgical indication. Conclusion. Based on the case report and literature review, it was suggested that early recognition of splenic rupture is essential for patient survival. Diagnosis is essentially performed by computed tomography, which defines the conduct, surgical or not. However, it has limitations as in the case reported where the rupture of the spleen camouflaged the presence of an accessory spleen. (author)