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False-positive Spleen Imaging: Splenic Cleft and Accessory Spleen

Following trauma, a 35-year-old man had a falling hematocrit. Radiocolloid imaging showed a superior pole splenic defect with a bilobed appearance (suggesting nearly complete trans-section). There was a small quantity of function below the main portion of the spleen. At surgery, the spleen was noted to have marked lobulation (perhaps congenital) to account for the upper pole defect and trans-splenic appearance of a tear. A small accessory spleen was present below the main organ, mimicking the appearance of organ disruption. Cases of false-positive radiocolloid images, suggesting trauma, are rare but do occur.