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

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.