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Situs inversus

Case contributed by James Sheldon
Diagnosis almost certain

Patient Data

Age: 25 years
Gender: Female
x-ray

Situs inversus and dextrocardia with a left sided arch noted. Pediatric sternal wires, right apical surgical clips and epigastric vascular coils. The heart is enlarged. Lungs and pleural spaces are clear.

Case Discussion

Situs inversus, is a rare anomaly (0.01% prevalence) in which there is mirror image of the normal arrangement of organs. It is generally an autosomal recessive condition although it can be X-linked or found in identical "mirror" twins.

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.

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