Accessory spleen in splenic trauma and reactive thrombocytosis

Abstract

We present the case of a 25-year-old male patient who underwent a splenectomy due to injury of the spleen accompanied by haemodynamic instability. Intraoperatively, an accessory spleen was identified in the left splenorenal space which remained intact and was salvaged during the operation. On the 3rd postoperative day, the platelet count began to rise, exceeding 1 × 106 / μL on the 6th postoperative day. He was started on aspirin, but 6 days later the platelet count had remained unchanged. A coagulation profile was obtained and a haematology consultation was requested, which did not advocate a change in treatment. Finally, on the 15th postoperative day the platelet count fell below 106 / μL and the patient was discharged with instructions to repeat a blood analysis after a week; aspirin was discontinued after the platelet count had fallen to 6 × 105 / μL. The development of reactive thrombocytosis in a splenectomized patient with an accessory spleen is an infrequently reported entity.