Laparoscopic excision of accessory splenic tissue not detected by CT and nuclear scan

Laparoscopic splenectomy is becoming the procedure of choice for refractory thrombocytopenia. Resection of accessory splenic tissue is necessary to pr event relapse of the symptoms. Whereas the results of open splenectomy are well known, the efficacy of open splenectomy is under evaluation. The patie nt presented is a 33-year old black female, with immune thrombocytopenia fr om systemic lupus erythematosus. Despite treatment with prednisone and gamm a globulin, the platelet count remained low. Preoperative CT and scan with Tc-99m sulfur colloid showed a normal spleen. Accessory splenic tissue was not detected. During laparoscopy an accessory spleen was seen and resected. Laparoscopy provides a magnified access to areas that cannot be visualized during open splenectomy, thus accessory splenic tissue can be identified a nd resected.