A 14-year-old boy presented with nausea and left-sidedabdominal pain of 2 days’ duration and had elevated whiteblood cells. Abdominal CT with contrast agent shows a 4×4×3.7-cm well-defined, hypodense structure in the splenichilumwithsurroundingfatstrandingandfreefluid(Fig.1). Itwas not a simple cyst and did not show significantenhancement. Differential diagnoses included complicatedpancreatic pseudocyst, mesenteric cyst and torsion of asplenule. US displays the lesion as a solid structure withidentical echogenicity to the spleen without blood flow(Fig. 2). Diagnosis of torsion of a splenule was made; thesplenule was later removed.Ectopic splenic tissue is a common anomaly (10–30% ofautopsies).Failedfusionofmesenchymal splenicbudsresultsin splenules in the left side of the abdomen, usually in thesplenic hilum (75%) [1, 2]. Torsion of a splenule is rare andimaging is usually inconclusive but an early US exam canprove the diagnosis, showing identical echo to the spleen andabsence of blood flow before necrosis develops.References