Multimodality imaging of developmental splenic anomalies: tips and pitfalls

Anomalies in number and location may occur during splenic development. This review aims to offer a brief overview of splenic function and embryology and a detailed account of the imaging appearances using different imaging techniques of the normal spleen and various congenital splenic anomalies including (1) abnormal viscero-atrial situs, (2) splenogonadal fusion, (3) intrapancreatic accessory spleen, (4) wandering spleen, and (5) splenosis. Emphasis is placed on the salient features that help radiologists recognise important associations (e.g., asplenia/polysplenia in situs abnormalities), avoid diagnostic pitfalls (e.g., mistaking intrapancreatic accessory spleen as pancreatic neoplasms), and potential complications (e.g., acute torsion in wandering spleen). The correct identification of the said anomalies from more sinister causes, such as malignancies, are essential, where early intervention is necessary. •Splenic anomalies can be divided into anomalies in number or in location.•Anomalies in number include accessory spleen, polysplenia or asplenia.•Anomalies in location include splenosis, splenogonadal fusion and wandering spleen.•The anomaly in number helps in determining the viscero-atrial situs of the patient.•The correct identification of anomalies in location could avoid unnecessary invasive surgery.