Situs inversus

Case contributed by Dr Kelly Fong

Presentation

2 day old ex-full term female infant with prenatally diagnosed situs inversus.

Patient Data

Age: Newborn
Gender: Female
X-ray

CXR demonstrating dextrocardia with situs inversus. Also note the R sided gastric bubble and L sided liver .

 

Ultrasound

Ultrasound images demonstrating liver on the left side

Ultrasound

Ultrasound images demonstrating heart on patient's right side

Ultrasound

Ultrasound image demonstrating spleen on patient's right side

Case Discussion

Classifications

“Situs” describes the positioning of the cardiac atria and thoracic and abdominal viscera

•Situs Solitus – the normal arrangement of thoracic and abdominal organs (eg left sided stomach, right sided liver)

•Situs Inversus – Exact mirror image of situs solitus. (eg right sided stomach, left sided liver). Prevalence of 0.01%

Situs Ambiguus – any in between configuration. Sometimes described as heterotaxy

Associations

•Congenital Heart Disease: there is a 3-5% incidence of CHD amongst patients with situs inversus. Most common congenital anomaly being TGA.

•Kartagener’s Syndrome:  50% of Kartagener’s patients have situs inversus but only 20% of patient’s with situs inversus have Kartagener’s.

 

In regards to our patient she was diagnosed with situs inversus prenatally. Post-natally, chest x-ray and abdominal ultrasound were obtained that confirmed the diagnosis. An echocardiogram was also obtained that demonstrated no evidence of congenital heart disease.

This case was submitted with supervision and input from:

Soni C. Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center

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Case information

rID: 49124
Case created: 10th Nov 2016
Last edited: 21st Nov 2016
System: Paediatrics
Inclusion in quiz mode: Excluded

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