A 7-year-old girl presented to the emergency department with upper abdominal pain of 1 week's duration. There were no other associated symptoms; the white blood-cell count, the erythrocyte sedimentation rate, and levels of C-reactive protein were normal. Ultrasonography and computed tomography (CT) scan with intravenous contrast were performed. The images revealed a 4-cm solid mass in the left upper quadrant. A 3-dimensional reconstruction of the CT scan showed the mass had a trophic vessel linking to the splenic hilum region, but the organ involved was not determined preoperatively (Fig 1). The large size of the mass, which was atypical for an accessory spleen, and the lack of proximity to the spleen made an exact diagnosis uncertain.
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Published online: February 27, 2008
Accepted: October 19, 2007
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.