Dual-Splenic Arterial Supply with Asymptomatic Splenorenal Venous Drainage: A Rare Association with Polysplenia Syndrome

Polysplenia syndrome is a rare congenital disorder characterized by multiple splenules and a spectrum of visceral and vascular anomalies. While abdominal vascular variations are well described, portosystemic and splenorenal shunts are typically reported in pediatric populations and are often symptomatic. We describe the incidental detection of dual splenic arterial supply with splenorenal venous drainage in an adult patient with polysplenia syndrome. A middle-aged female presented with intermittent abdominal pain. Contrast-enhanced computed tomography revealed multiple splenules without a dominant spleen, intestinal malrotation, dorsal pancreatic agenesis, and azygous continuation of the inferior vena cava. The splenules were supplied by two splenic arteries, arising from the celiac trunk and the superior mesenteric artery, and drained via a common splenic vein into a retroaortic left renal vein. This case highlights a rare, incidentally detected splenic vascular variant in adult polysplenia and underscores the importance of carefully evaluating vascular anatomy in such patients due to potential surgical and clinical implications.