Incidental Heterotaxy Syndrome With Polysplenia and Inferior Vena Cava Agenesis Identified During Trauma Evaluation

This case report describes a young adult male in his 20s who was admitted following a high-speed motor vehicle collision resulting in polytrauma, including a femoral shaft fracture. Initial computed tomography performed for polytrauma incidentally revealed heterotaxy syndrome with polysplenia; agenesis of the inferior vena cava with hemiazygos continuation; and intestinal malrotation. Orthopedic management proceeded uneventfully. This case highlights several important learning points: inferior vena cava agenesis is associated with an increased risk of venous thromboembolism, necessitating heightened awareness and appropriate thromboprophylaxis in trauma and perioperative settings; associated venous anomalies should be clearly documented to inform future procedural planning and patient safety; and asymptomatic intestinal malrotation identified in adulthood can often be managed conservatively with surveillance rather than intervention.