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Joseph Junewick, MD FACR
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Situs Inversus

Case Detail

Anatomy: Chest
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 6 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CR CT
Activities:
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History

15 year old with congenital heart disease.


Case Images


Diagnosis

Situs Inversus

Findings

CR – Right aortic arch, cardiac apex and stomach with previous median sternotomy.

CT – Right sided stomach and single spleen and left sided liver.

Discussion

Situs inversus refers to an anatomic arrangement where the systemic atrium is on the left with a left-sided trilobed lung, liver, gallbladder, and inferior vena cava and the pulmonary atrium is on the right with a right-sided bilobed lung, stomach, single spleen, and aorta. The cardiac apex is on the right. Situs inversus is seen in 0.01% of the population, but only 3-5% of these patients have congenital heart disease. Atrioventricular discordance and transposition are the most common abnormalities. Kartagener syndrome (which consists of situs inversus, nasal polyposis with chronic sinusitis, and bronchiectasis) is present in 20% of all patients with situs inversus. The bronchiectasis is caused by compromised mucociliary transport secondary to dynein protein structural and functional abnormalities.

Reference

Applegate KE, Goske MJ, Pierce G, et al. Situs Revisited: Imaging of the Heterotaxy Syndrome. RadioGraphics (1999); 19: 837-852.



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