Situs inversus totalis

Case contributed by Mohamed El Deen
Diagnosis almost certain

Presentation

An asthmatic patient came to the ER with an acute attack of shortness of breath. He is a smoker - smoked 1 pack per day for 4 years.

Patient Data

Age: 25 years
Gender: Male
x-ray

There is bronchiectasis, alveolar infiltrations in both lungs, and congestion with peribronchial thickenings. There is also dextrocardia, a right-sided aortic knuckle, a right-sided gastric air bubble and left-sided liver.

ct

Bilateral pulmonary congestion, peribronchial thickening, and widespread bronchiectasis. The cardiac apex, aortic knuckle, and stomach are on the right side, and the liver is on left side.

Case Discussion

Situs inversus totalis in addition to lung bronchiectasis raises the flag of Kartagener's syndrome. Semen analysis has been declined by the patient so there is no confirmation of the diagnosis but the imaging is strongly supportive.

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