Chapter 43

### 1. Polysplenia

###### Figure 43-1

Polysplenia.

There are multiple homogeneous nodules (arrows) in the left upper quadrant on this longitudinal sonographic image. The kidney (K) is inferior and ventral to the splenules.

### 2. Polysplenia

###### Figure 43-2

Polysplenia.

A. A transverse sonographic image of the left upper quadrant demonstrates multiple splenic masses (arrows) that have normal echogenicity. B. The splenules (arrow) enhance intensely relative to liver on this axial contrast-enhanced CT image.

### 3. Asplenia and heterotaxy

###### Figure 43-3

Asplenia and heterotaxy.

Contrast-enhanced CT image shows an abnormal symmetric character of the liver, and no visible spleen. The gallbladder is midline. The aorta is on the right. The stomach is deviated slightly toward the midline by the liver.

### 4. Polysplenia

###### Figure 43-4

Polysplenia.

There are multiple enhancing foci of splenic tissue in the left upper quadrant on this contrast-enhanced CT image. The azygous vein is prominent due to interruption of the IVC.

### 5. Heterotaxy

###### Figure 43-5

Heterotaxy.

A posterior image from technetium-labeled heat-damaged erythrocyte scintigraphy shows intense uptake in the spleen. The spleen is on the left, but has an abnormal shape and is more medial than normal. Blood pool activity allows visualization of the heart, the apex of which is directed to the right (arrow). The faintly visualized liver has a transverse configuration.

### 6. Polysplenia

###### Figure 43-6

Polysplenia.

A posterior technetium-labeled heat-damaged erythrocyte scintigraphic image of the abdomen shows an anomalous right-sided location of the spleen (arrows). The spleen consists of 2 masses. Uptake in the liver is fainter than in splenic tissue. This transverse morphology of the liver is common in patients with heterotaxy.

### 7. Asplenia: heterotaxy

###### Figure 43-7

Asplenia: heterotaxy.

A. Anterior and B. posterior 99mTc sulfur colloid scintigraphy images show a transverse, symmetric configuration of the liver, and no splenic activity.

### 8. Accessory spleen

###### Figure 43-8

Accessory spleen.

An oval splenule (arrow) has identical echogenicity as the adjacent spleen on this transverse sonographic image.

### 9. Accessory spleen

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