Coincidence of left isomerism, malposition of cecum, dorsal pancreatic agenesis, and retroaortic left renal vein: A case report

Authors

Keywords:

Left isomerism, Computed tomography, Dorsal pancreatic agenesis, Retroaortic left renal vein, Malposition of cecum

Abstract

Polysplenia / heterotaxy syndrome is a very rare condition that occurs as a result of the maldistribution of the thoracic and abdominal organs. It is examined in two groups with different clinical features and anatomical variations: right and left isomerism. This paper reports the case of a 47-year-old female patient who underwent a non-contrast computed tomography (CT) examination due to right flank pain and suspicion of a renal stone and presented with the findings of left isomerism; i.e., accompanied by intraabdominal variations. On abdominal CT examination, stomach and multiple spleen were localized in the right upper quadrant, and the liver had a midline localization. The interruption of the inferior vena cava with azygos continuation were also detected. The hepatic veins were draining directly into the right atrium. In the literature, a retroaortic left renal vein and dorsal pancreatic agenesis have been individually reported to coexist with left isomerism, but no other case of the coincidence of these three anomalies has been described, which makes the current case report significant. Having knowledge of anatomical variations and clinical status can prevent misdiagnosis, and imaging findings are crucial in the planning of a possible surgical procedure.

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References

Jung JE, Hur JH, Jung MK, Kwon A, Chae HW, Kim DH, et al. Diabetes mellitus due to agenesis of the dorsal pancreas in a patient with heterotaxy syndrome. Ann Pediatr Endocrinol Metab. 2017 Jun;22(2):125-8.

Gupta AC, Herts B. Heterotaxia with polysplenia. J Urol. 2015 Sep;194(3):801-2

Yildiz AE, Ariyurek MO, Karcaaltincaba M. Splenic anomalies of shape, size, and location: pictorial essay. Scientific World Journal. 2013 Apr 21;2013:321810.

De Wailly P, Metzler P, Sautot-Vial N, Olivier D, Meunier B, Faure JP. Pre-duodenal portal vein in polysplenia syndrome: clinical effects and surgical application. Surg Radiol Anat. 2011 Jul;33(5):451-4.

Gupta R, Soni V, Valse PD, Goyal RB, Gupta AK, Mathur P. Neonatal intestinal obstruction associated with situs inversus totalis: two case reports and a review of the literature. J Med Case Rep. 2017 Sep 18;11(1):264.

Douard R, Feldman A, Bargy F, Loric S, Delmas V. Anomalies of lateralization in man: a case of total situs inversus. Surg Radiol Anat. 2000;22(5-6):293-7.

Varga I, Babala J, Kachlik D. Anatomic variations of the spleen: current state of terminology, classification, and embryological background. Surg Radiol Anat. 2018 Jan;40(1):21-9.

Seo HI, Jeon TY, Sim MS, Kim S. Polysplenia syndrome with preduodenal portal vein detected in adults. World J Gastroenterol. 2008 Nov 7;14(41):6418-20.

Pagkratis S, Kryeziu S, Lin M, Hoque S, Bucobo JC, Buscaglia JM, et al. Case report of intestinal non-rotation, heterotaxy, and polysplenia in a patient with pancreatic cancer. Medicine (Baltimore). 2017 Dec;96(49):e8599.

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Published

2019-11-01

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Section

Case Report

How to Cite

1.
Emekli E, Gündoğdu E, Kebapçı M. Coincidence of left isomerism, malposition of cecum, dorsal pancreatic agenesis, and retroaortic left renal vein: A case report. J Surg Med [Internet]. 2019 Nov. 1 [cited 2024 Dec. 13];3(11):812-4. Available from: https://jsurgmed.com/article/view/573375