Anteriorly Placed Splenic Vein Associated with Situs Inversus Totalis: A Rare Radiological Observation

Abstract

Anterior placement of the splenic vein is an extremely rare vascular anomaly, with only a few cases reported in the literature. This report describes a 34-year-old male with persistent mild hyperamylasemia in whom contrast-enhanced computed tomography revealed situs inversus totalis and an unusual anterior course of the splenic vein.

The vein originated from the splenic hilum and coursed anterior to the pancreas before joining the portal vein, without evidence of thrombosis, pancreatitis, or ductal obstruction. The patient remained clinically stable under conservative management. This case represents, to the best of our knowledge, the first reported association of an anteriorly placed splenic vein with situs inversus totalis. The coexistence of these findings supports a possible shared embryological mechanism involving abnormal pancreatic rotation and laterality disturbance. Recognition of this rare vascular configuration is important for accurate radiological interpretation and for preventing potential complications during surgical or interventional procedures.