Polysplenia in an adult patient.

A 45-year-old woman was referred for CT of the abdomen due to endoscopically detected esophageal varices. The patient complained of dizziness and long-term epigastric pain. The CT scan showed five aberrant splenic nodules (Picture a), a short pancreas (Picture b, arrowhead), a preduodenal portal vein (Picture b, arrow), intestinal malrotation (Picture c) and a symmetric midline position of the liver (Picture c), all of which were consistent with a diagnosis of polysplenia syndrome. Polysplenia syndrome (PSS) is a rare congenital disease that occurs in patients with two or more spleens and various organ anomalies. Unlike that occurring in children, PSS in adults is usually asymptomatic and discovered incidentally since cardiovascular anomalies are minor or nonexistent (1). However, anomalies of the abdominal viscera sometimes lead to clinical manifestations or represent a surgery danger (2). Fortunately, conducting a careful analysis of systemic anomalies, which is required in medical evaluations, is therefore facilitated using modern imaging techniques.