IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Situs inversus

Case contributed by Kelly Fong
Diagnosis certain

Presentation

Ex-full term infant with prenatally diagnosed situs inversus.

Patient Data

Age: 2 days
Gender: Female
x-ray

Dextrocardia with situs inversus. Note the right-sided gastric bubble and left-sided liver.

ultrasound

Ultrasound images demonstrating heart and spleen on the right, with liver on the left.

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: 3-5% incidence inpatients with situs inversus, most common associated anomaly being transposition of the great arteries (TGA).
  • Kartagener syndrome: 50% of Kartagener syndrome patients have situs inversus but only 20% of patient’s with situs inversus have Kartagener syndrome.

In regards to our patient she was diagnosed with situs inversus prenatally. Post-natally, chest x-ray and abdominal ultrasound were obtained, which confirmed the diagnosis. An echocardiogram was also obtained, which 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

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.