Situs inversus totalis

Case contributed by Tito Alfredo Atencia Rincón

Presentation

Female patient attends the pediatric ward because of a palpitations sensation on the right side of the chest at the end of the school's sports practices. No past medial history. Her pediatrician finds a totally healthy patient, however, he listens to the heartbeat at the level of the right costal margin, requesting an imaging study of the thorax.

Patient Data

Age: 13 years
Gender: Female

Chest and upper abdomen

x_ray

Cardiac silhouette projected in the right hemithorax.

The hepatic silhouette is observed in the left hemiabdomen. Distribution of colonic gas is in the upper right quadrant of the abdomen.

There was no error in the radiological technique.

Abdomen

ultrasound

Intra-abdominal structures of normal size, contour and echogenicity. The intra-abdominal organs were objectively located in reverse.

Case Discussion

Situs inversus totalis (SIT) is a rare syndrome in which all the organs are mirrored in the body. It occurs with an estimated frequency in 1 to 2 births per 10,000. Unlike situs inversus, all organs are involved.

In this case, the patient's heart was found on the right side of the chest, which is known as situs inversus with dextrocardia. In these situations, the affected organ usually has anomalies, whereas in SIT, the organs usually function correctly and the patients are usually otherwise healthy.

SIT is most often described as part of the ciliary dyskinesia syndrome, also known as Kartagener syndrome (situs inversus, bronchiectasis, sinusitis), usually diagnosed during childhood.

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