title: Preduodenal portal vein, intestinal malrotation, polysplenia, and interruption of the inferior vena cava: a review of anatomical anomalies associated with gastric cancer.
abstract: OBJECTIVE
  Anatomical anomalies of visceral organs associated with gastric cancer are extremely rare. Here, we report a case of preduodenal portal vein (PDPV), intestinal malrotation, interruption of the inferior vena cava (IVC), and polysplenia associated with gastric cancer in an adult patient, together with a review of the literature on the anomalies of visceral organs associated with gastric cancer.
  
  
  METHODS
  We describe the diagnosis and surgical treatment in a 63 year-old man who had a preoperative diagnosis of PDPV, intestinal malrotation, interruption of the IVC with azygos continuation, and polysplenia associated with gastric cancer. Fifteen reports, in the English literature up to 2011, on visceral organ anomalies detected in gastric cancer patients were identified by searching Medline.
  
  
  RESULTS
  All of the 15 cases of anomalies associated with gastric cancer, including the present case, were correctly diagnosed by preoperative imaging. Situs anomaly was the most frequent anatomical anomaly detected, and PDPV was observed in only four cases. In 12 cases, gastrectomy was performed, and gastrojejunostomy was done in 1 case.
  
  
  CONCLUSIONS
  Although embryological anomalies such as PDPV, intestinal malrotation, interruption of the IVC, and polysplenia are rarely encountered in abdominal surgery, surgeons must be aware of their possible existence and be able to recognize them to avoid major intraoperative injuries.
authors.affiliation: Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho Naka-ku Yokohama, Kanagawa, 231-8553, Japan. mimatsu.kenji@yokochu.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Mimatsu
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Oida
authors.forename: Hisao
authors.initials: H
authors.lastname: Kano
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawasaki
authors.forename: Nobutada
authors.initials: N
authors.lastname: Fukino
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Kida
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kuboi
authors.forename: Sadao
authors.initials: S
authors.lastname: Amano
mesh_terms: D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging*; D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D004065:Digestive System Abnormalities / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D033162:Incidental Findings; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011169:Portal Vein / Q000002:abnormalities; D018570:Risk Assessment; D013154:Spleen / Q000002:abnormalities; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000002:abnormalities
chemical_list: D003287:Contrast Media
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