Situs inversus

Last revised by Dr Jeremy Jones on 19 Sep 2021

Situs inversus, (rare plural: sitūs inversi) short form of the Latin “situs inversus viscerum”, is a term used to describe the inverted position of chest and abdominal organs. It is called situs inversus totalis when there is a total transposition of abdominal and thoracic viscera (mirror image of internal organs normal positioning). Normal positioning of the organs - as found in the majority of individuals is called situs solitus.

Situs inversus is usually associated with dextrocardia (true mirror image) with only 3-5% incidence of congenital heart disease, most commonly transposition of the great vessels. Of these patients, 80% have a right-sided aortic arch. Situs inversus with levocardia (which is much rarer: 0.00005%) congenital heart disease is found in 95% of patients 4.

Up to 20% of patients with situs inversus can have Kartagener syndrome 3 which comprises a subgroup of primary ciliary dyskinesia.

Situs inversus can be associated with both asplenia 5 or polysplenia (rarely) 6.

Complete situs inversus is associated with the absence of inferior vena cava 5.

Imaging features on chest radiograph to be evaluated are:

  • location of the heart apex
  • location of the aortic arch
  • locations of stomach bubble and liver

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Cases and figures

  • Case 1: chest radiograph
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  • Case 2
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  • Case 3: ultrasound
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  • Case 4: CT
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  • Truncus arteriosu...
    Case 5: with concurrent congenital cardiac anomaly
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  • Case 6: with Kartagener syndrome
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  • Case 7
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  • Case 8
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  • Case 9
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  • Case 11
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  • Case 10
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  • Case 12
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  • Case 13
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  • Case 14
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  •  Case 15
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  • Case 16
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  • Case 17: situs inversus totalis
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  • Case 18
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  • Case 19: with gallstone ileus
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  • Case 20: situs inversus totalis with left azygos fissure
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  • Case 21: swallowed coin foreign body with situs inversus
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  • Case 22
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  • Case 23
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  • Case 23: with gastric cancer
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  • Case 24: Situs inversus totalis with horseshoe kidney
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  • Case 24: Situs inversus totalis with horseshoe kidney
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