In (b), a 59-year-old …Figure 4Axial contrast enhanced CT image (a), contrast enhanced T1-weighted image at arterial (b) and venous phases (c) show an intrapancreatic nodular mass in a 63-year-old female patient. The mass has similar density Enzastaurin MM at CT and contrast enhancement pattern at …Figure 5Accessory spleens can locate at the wall of stomach or bowel. Axial contrast-enhanced CT image (a) with oral contrast medium shows a nodular hyperdense lesion (arrow) indenting the posterior wall of the stomach in a 57-year-old female patient. The follow-up …Figure 6Axial contrast enhanced CT image of a 29-year-old male patient shows splenopancreatic fusion anomaly. Wandering or ectopic spleen is a rare entity in which the spleen is located outside of its normal location.

Its reported incidence in several large series of splenectomies is less than 0.5% and mainly detected in children and women between 20 and 40 years of age. The reason for the wandering spleen is the laxity or maldevelopment of the supporting splenic ligaments, and the spleen can be found in any part of the abdomen related to the length of the vascular pedicle.Wandering spleen may be incidentally detected or may cause different degrees of abdominal pain related to acute, chronic, and intermittent torsion of the vascular pedicle. Ultrasonography and CT are the most used methods for diagnosis. Imaging findings of wandering spleen are the absence of the spleen in its normal position and a mass located anywhere in the abdomen or pelvis with enhancement pattern of a normal splenic tissue (Figure 7).

In case of torsion, a ��whirl�� appearance of its twisted pedicle and impaired enhancement of the mass can also be helpful. The treatment choice of a wandering spleen is splenopexy. Splenectomy is required only in case of infarction, which can be diagnosed radiologically. Doppler ultrasonography and contrast enhanced CT can be used to evaluate splenic vascularization. In splenic torsion, doppler ultrasonography shows no flow within the spleen and a low diastolic velocity with an elevated resistive index in the proximal splenic artery. Contrast enhanced CT can show a total absence of or heterogeneous enhancement pattern within the spleen related to partial or total infarction (Figure 8).

If there is a contraindication for contrast enhanced CT, findings of infarction on unenhanced CT are low attenuation of the spleen relative to the liver, a hyperdense intraluminal filling defect in the splenic vessels Entinostat indicating an acute thrombus, and high density of the splenic capsule compared with the parenchyma (��rim�� sign) [1, 6, 9, 10]. Figure 7Coronal venous phase MIP image shows a wandering spleen (star) located at pelvis and its vascular pedicle (white arrow) originating from splenic artery (black arrow).