Despite their small size, accessory spleens are clinically important. Hematologists have long emphasized their occasional role in the reexacerbation of hematologic disease after initially beneficial splenectomy.1-7 Accessory spleens have been known to rupture,8 twist on their pedicles and strangulate,5,6,9 cause bowel obstruction,10 and produce defects on upper gastrointestinal radiographs suggestive of gastric neoplasms.11,12 Although accessory spleens are well recognized as a cause of disease, there is little published evidence to suggest that their apparent frequency may be the result of disease.
Anatomy textbooks tend to mention the infrequent presence of accessory spleens as an anatomic fact devoid of pathological significance. Settle states, "the accessory spleen is an anomaly [which is the] result of a development abnormality in the embryo."6 Downey13 and Arey14 share this belief. To some degree this is true, as substantiated by the occasional presence of accessory spleens in normal