Asplenia and Polysplenia

Abstract

Abdominal sonograms on seven patients with asplenia syndrome and six patients with polysplenia syndrome were retrospectively reviewed. All seven patients with asplenia had a horizontal symmetric configuration of the liver, and three patients had the cardiac apex opposite the stomach. Four of six patients with polysplenia syndrome had a symmetric configuration of the liver, and in five patients the cardiac apex was opposite the stomach. In two of six patients with polysplenia syndrome, multiple spleens were observed sonographically, and the spleen was noted sonographically to be lobulated in three of the patients. The spleen was not visible on at least one sonographic examination in three patients with polysplenia in which the presence of the spleen was subsequently documented. Four patients with polysplenia syndrome showed an interruption of the inferior vena cava. The authors conclude that the knowledgeable sonographer can usually identify the complex abdominal anomalies that are observed in these syndromes if an organized survey of the abdominal organs, particularly the venous structures, is performed. The spleen may be difficult to identify in some patients, and other abdominal anomalies, especially interruption of the interior vena cava can serve as valuable clues that the spleen is probably present, and further search for it is indicated.