Remnant spleen causing recurrent idiopathic thrombocytopenic purpura

Tanya Castelino, MD, Amani Munshi, MD, Liane S Feldman, MD, FRCSC, FACS. Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre

Idiopathic thrombocytopenic purpura (ITP) occurs at a rate of 3.3 adults per 100,000. The incidence of accessory spleen is reported at anywhere from 5 to 44%, depending on the method of detection, with laparoscopic evaluation being more accurate than preoperative CT imaging. Approximately 18% of patients treated with splenectomy for ITP will redevelop clinical ITP due to the presence of residual splenic tissue. We present a case of a female patient who remotely underwent laparoscopic splenectomy for ITP. After over a decade of remission, the patient presented with recurrent ITP due to remnant splenic tissue. This video describes the operative technique in a laparoscopic remnant splenectomy.

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