Highlights Polysplenia is a complex polymalformative syndrome that includes a spectrum of visceral and vascular anatomical abnormalities; extremely undiscovered in adulthood. A rare case of polysplenia syndrome showing an exceptional association between preduodenal portal vein, dorsal pancreas agenesis and polysplenia on gastric adenocarcinoma. Surgeons must be aware of their possible existence and be able to recognize them to avoid major intraoperative injuries. Surgeons must have a perfect knowledge of the reference anatomy and the exploration of anatomical variations in imaging before surgical exploration. PDPV is believed to pose increased risk to gastric cancer patients during gastrectomy and lymph node dissection around the hepatoduodenal ligament.

Phytobezoars are concretions of indigested fruit and vegetables fibers in the gastrointestinal tract. The past of gastric surgery is most common risk factor of phytobezoar. We present the case of a 39-year-old female was admitted to the emergency department and who presented with small bowel obstruction due to phytobezoar, her past medical history was marqued by truncal vagotomy and simple suture recurrent perforated gastric ulcer 15 years earlier. Her postoperative recovery was uneventful.

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