SIR 2005 Film Panel Case: Heterotaxia with Polysplenia

Polysplenia syndrome with complex heart disease and jejunal atresia with malrotation in neonate: A case report

Polysplenia is heterotaxy syndrome or bilateral left-sidedness. We report a case of polysplenia syndrome in order to draw attention to this rare syndrome that must be excluded in an infant presenting with congenital heart disease and intestinal malformations.

Laparoscopy-assisted distal gastrectomy in a patient with early gastric cancer and polysplenia

A 44-year-old woman is presented who was referred for further evaluation and surgical treatment of gastric cancer detected on a routine health evaluation. Endoscopic examination with biopsy revealed about a 1-cm early gastric cancer of signet-ring cell type at the lesser curvature side of the antrum. A computed tomography scan of the abdomen confirmed the findings of intestinal malrotation, polysplenia, and a large enhancing mass in the uterus. The results of blood testing and echocardiography were within normal limits. The patient underwent laparoscopy-assisted distal gastrectomy and transvaginal hysterectomy for early gastric cancer and uterine myoma. A lobulated spleen in several parts, intestinal malrotation, and a very large uterine mass were identified during the laparoscopic surgery. The postoperative course was uneventful. This case illustrates the importance of thorough preoperative anatomic assessment, especially for laparoscopic surgery in patients with anatomic abnormalities.

Congenital anomalies of the spleen

Various congenital anomalies may affect the spleen, starting with common anomalies, such as an accessory spleen, up to rare conditions such as a wandering spleen and polysplenia. Most of these anatomic variants have no clinical significance; they need, however, to be recognized by the radiologist as such. Awareness of these variants is important for the radiologist to interpret the findings correctly and avoid mistaking them for a clinically significant abnormality. In this review we illustrate the spectrum of congenital anomalies of the spleen and stress pitfalls and possible complications resulting from these anomalies.