Choledocholithiasis in a patient with left isomerism (polysplenism)

Case contributed by Dr James Harvey

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
  • the lungs are clear
  • right-sided gastric bubble
  • horizontal fissure not seen
  • cardiac apex directed to the left
  • a radiodense calculus is present within the distal CBD and there is intrahepatic and extrahepatic bile duct dilatation. Cholelithiasis also evident
  • the liver is midline
  • right-sided stomach
  • polysplenism
  • left-sided IVC

Case Discussion

Left isomerism (aka polysplenism) is a heterotaxy syndrome characterized by multiple spleens, malposition of the abdominal viscera, abnormalities of the IVC, and cardiac abnormalities.

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Case information

rID: 82069
Published: 13th Sep 2020
Last edited: 15th Sep 2020
Inclusion in quiz mode: Included