Presentation
Change in bowel habits.
Patient Data
Age: 45 years
Gender: Male
From the case:
Polysplenia syndrome - rectal mass
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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.