Presentation
Epigastric pain and shortness of breath. Background of heart failure, CKD stage IV, COPD. Known congenital syndrome withheld.
Patient Data
Age: 70 years
Gender: Female
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Info
- the lungs are clear
- right-sided gastric bubble
- horizontal fissure not seen
- cardiac apex directed to the left
Abdomen and pelvis
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Info
a radiodense calculus is present within the distal CBD and there is intrahepatic and extrahepatic bile duct dilatation. Multiple gall bladder calculi.
the liver is midline
right-sided stomach
polysplenism
left-sided IVC
nonrotation of the bowel
dorsal pancreatic agenesis
Case Discussion
Left isomerism (aka polysplenism) is a heterotaxy syndrome characterised by multiple spleens, malposition of the abdominal viscera, abnormalities of the IVC, and cardiac abnormalities.
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