What are the the two main differential diagnoses of multiple spleens?
Polysplenia syndrome. Splenosis.
Can you name 3 suggested factors for polysplenia aetiology?
1.embryogenic 2.genetic 3.teratogenic
The right lung is bilobed (absence of the horizontal fissure) with the presence of an inferior accessory fissure. Bilateral hyparterial main bronchi.
There is a narrowing of the proximal descending aorta with known aortic coarctation that underwent surgery in childhood and a residual stenosis remains.
There is SVC duplication.
Multiple spleens of different sizes (oval-shaped) are located in the left upper quadrant.
Right-sided duodenal-jejunal junction relative to the mid-line. Small intestine with a right-sided location primarily. On the other hand, the large colon is located on the left for the most part.
Dorsal pancreatic agenesis.
Additional findings:
aortic prosthesis of the ascending aorta with periprosthetic retrograde contrast filling (might be mistaken for aortic dissection - pitfall)
aortic valve replacement
dilated ascending aorta
enlargement of the caudate lobe of the liver
atypical position of the gallbladder (ventral and adjacent to the anterior abdominal wall)
mild prostatic hypertrophy