First CT staging for patient with ascending colon neoplasm screened by colonscopy
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- Inferior vena cava (IVC) draining in a dilatated azygos vein
- No evidence of intrahepatic portion of IVC
- Multiple splenules and stomach in right hypochondrium
- Cecum mobile in the left iliac region.
- Liver hemangioma at right lobe (segment VII)
- Colon neoplasm not CT-appreciable due to artefacts caused by hip metallic implants and no significative focal parietal thickening
Azygous continuation of the inferior vena cava is a vascular congenital anomaly. In this case it was associated with right-sided multiple spleens, gastrointestinal isomerism and ceacum mobile and it is possible to suspect Polysplenia syndrome.
The patient had no significant clinical history before the colonscopy and this was the first Body-CT performed. So her anatomic variant was unacknowledged.
Polysplenia syndrome is usually symptom-free, but describing congenital anatomic variants is useful in case of thorax/abdominal surgery.
- Applegate KE, Goske MJ, Pierce G, Murphy D. Situs revisited: Imaging of the heterotaxy syndrome. Radiographics.1999;19:837-852