Accessory spleens, mixed hiatal hernia, and incisional hernias: a complex case of multidisciplinary surgical management

Accessory spleens, mixed hiatal hernia, and incisional hernias: a complex case of multidisciplinary surgical management

Accessory spleen, Hiatal hernia, Incisional hernia, Nissen fundoplication, Splenectomy, Multimorbidity,
Case report

Abstract
Background Accessory spleens, arising from incomplete fusion during embryogenesis, are frequent developmental
anomalies detected incidentally in abdominal imaging studies. Despite surgical advancements, post-laparotomy
incisional hernias persist, while hiatal hernias, common in older adults, often present asymptomatically.
Case presentation A 55-year-old male presented with abdominal pain, chronic vomiting, and gastrointestinal
bleeding. Evaluation unveiled a mixed hiatal hernia alongside multiple accessory spleens, necessitating surgical
intervention. A midline incision facilitated adhesion release, hernia repair, and a 360-degree Nissen fundoplication.
Postoperatively, the patient stabilized, discharged with a liquid diet and medications. Histopathological analysis
confirmed benign findings, emphasizing successful complex abdominal condition management.
Conclusion Comprehensive assessment is vital for patients with intricate gastrointestinal symptoms and surgical
histories. Accurate diagnosis and intervention, encompassing accessory spleen excision and hernia repair, resulted in
notable clinical enhancement devoid of complications.
Keywords Accessory spleen, Hiatal hernia, Incisional hernia, Nissen fundoplication, Splenectomy, Multimorbidity,
Case report

Hamdah Hanifa1 , Mohi Alddin Moustafa Mahouk1 , Fadiah Hazem Albaroudi2 , Enas Saleem Khallouf3
, Dana

Abu Nokta1* , Ranim Alrihani1 , Basil Alsaleh4 , Youssef Zeeb5

, Ramez Altair5

, Malek AlBalkhi5

, Rawad Asami5
and

Abdullah Shekh Najjaren5

https://doi.org/10.1186/s12245-025-00917-0

2025

Peri Irawan

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