Polysplenia syndrome - rectal mass

Case contributed by Amro Omar
Diagnosis almost certain

Presentation

Change in bowel habits.

Patient Data

Age: 45 years
Gender: Male

Contrast-enhanced CT shows features of situs ambiguous with left isomerism:

  • polysplenia along right side, with no dominant (parent) spleen
  • azygous continuation of the IVC
  • midline liver
  • intestinal malrotation, with duodenum coursing entirely anterior to portosplenic veins and transverse colon passing between superior mesenteric artery and aorta

Additionally, there is an irregular rectal mass along right wall of rectum. Several hypoattenuating liver lesions are suspicious for liver metastases.

Case Discussion

Axial CT demonstrates typical features of polysplenia syndrome. Furthermore, the irregular rectal mass (presumably a rectal carcinoma) raises suspicion that several liver lesions represent hepatic metastases

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