Detection of multiple accessory spleens in a patient with chronic idiopathic thrombocytopenia purpura

Chronic idiopathic thrombocytopenia purpura is an immunologically mediated disorder resulting in disordered platelet kinetics and potentially life-thr eatening thrombocytopenia, Failure of medical therapy is an indication for splenectomy, and responses are seen in 70% of patients after this procedure . An important cause of relapse after splenectomy is the presence of access ory spleens. The authors describe a patient with chronic idiopathic thrombo cytopenia purpura who had a relapse of symptoms 4.5 years after splenectomy . Tc-99m heat-denatured RBC planar and SPECT studies revealed the presence of multiple (more than 13) accessory spleens, but few of them were localize d anatomically using computed tomography.