1] The pathophysiologic foundation of this rare complication is not well-understood but is believed to be associated with stretching of the
splenocolic ligament secondary to the movement of colonoscope causing tear in the splenic capsule.
The congenital form results from a lack of development of the primary ligamentous attachments of the spleen: the gastrosplenic, splenorenal,
splenocolic splenophrenic, splenopancreatic, presplenic fold, pancreaticocolic, and phrenocolic ligaments (4).
Present in approximately 10% of the population, accessory spleens arise from the fusion failure of the splenic anlage and reside in close proximity to the
splenocolic and gastrosplenic ligaments.
The lower pole of the spleen was mobilized next by dividing the
splenocolic ligament to bring down the splenic flexure of the colon followed by the dissection of the posterior attachments (splenophrenic and splenorenal ligaments) with the help of ultracision.
Dissection with an ultrasonic dissector (Ultracision LCS-5, Ethicon, Cincinnati, Ohio, USA) was commenced by mobilisation of the inferior pole of the spleen after division of the
splenocolic ligament.
