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Volume 79 - 2016 - Fasc.2 - Clinical images

Computed tomography findings of polysplenia syndrome with multiple anomalies

A 54-year-old patient presented to our hospital with the symptoms of stomach ache, weakness, loss of appetite and weight loss. The patient had mild abdominal sensi- tivity during physical examination ; the results of other systemic examinations were normal. Laboratory findings showed anemia. Since the patient's symptoms were ac- companied by weight loss, abdominal CT examination was performed to rule out any malignancies. The abdom- inal CT examination showed a picture consistent with partial situs inversus. The liver was located on the left, the spleen on the right and the heart was in its normal position. The cecum was observed in the lower left quad- rant. Multiple spleens located in the upper right quadrant were observed (Fig. 1). Pancreas was ectopically located in the upper left quadrant and surrounded the second part of the duodenum. A diverticular formation was detected in the second part of the duodenum.


A rarely seen biliary variation : Right posterior and right anterior hepatic ducts were opening to the cystic duct

The anatomy of the intrahepatic bile ducts, is consis- tent with the segmental anatomy of the liver, according to Couinaud classification(1). However there are some variations in this system that can cause significant mor- bidity and mortality during cholecystectomy. Several classifications have been proposed for biliary opening anomalies. Opening of the whole right main bile ducts to the cystic duct is an extremely rare condition and classi- fied as type-e according to the champetier classification (Table 1) (2).