ASYMPTOMATIC SITUS AMBIGUOUS WITH LEFT- SIDED ISOMERISM & POLYSPLENIA : AN UNUSUAL INCIDENTAL PRESENTATION sejalgrover98@gmail.com

PE006

ASYMPTOMATIC SITUS AMBIGUOUS WITH LEFT- SIDED ISOMERISM & POLYSPLENIA : AN UNUSUAL INCIDENTAL PRESENTATION

2

 

 

 

 

India

Oral or Poster

The first anatomical-clinical description of this type of pathology was made by Helwig EB in 1929 as a type of situs ambiguous characterized by left isomerism, associated with a group of visceral anomalies of unknown etiology, which includes the presence of splenic nodules outliers. The term left isomerism includes a group of morphological variations that cause part of the internal organs to be located to the right side of the midline with their tendency to adopt characteristics of those of the same name on the left side.

Incidental detection on radiographs during pre-operative evaluation

On the CT (computed tomograph) examination with contrast material, the following can be observed: Liver is predominately in the midline more on the left side. Stomach is distended and is on right side with gastro-duodenal junction seen in the midline. GB is in midline and fundus slightly towards left side. Multiple spleens (3) suggestive of polysplenia in the right hypochondrium with entire duodenum in the midline and towards left, anterior to head of pancreas. Part of body and tail of pancreas are not visualized suggestive of dorsal pancreatic agenesis. Head and uncinate process of pancreas seen towards the left of midline with body seen in the midline. Reversal of SMA-SMV relation with SMA noted right and posterior to the SMV.

This case contributes to the limited literature on this rare abnormality. The treatment and follow-up of patients with heterotaxy syndrome are not standardized and must be personalized according to each patient's unique symptoms and findigs.