Situs inversus

Newborn with
abnormal prenatal echocardiogram after PICC placementAXR AP shows a left lower extremity PICC and a right femoral venous catheter both of whose tips project over a left-sided inferior vena cava. An umbilical venous catheter tip projects over the ductus venosus. An umbilical arterial catheter tip projects at the level of T9. Nasogastric tube tip projects over the stomach in the right upper quadrant. Feeding tube tip projects transpylorically over the duodenal bulb. The cardiac apex is in the right chest.The diagnosis was appropriate position of the PICC and low malposition of the umbilical venous catheter in a patient with situs inversus.
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Kartageners
syndrome. Right sided spleen and aorta Left sided liver and IVC
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Kartagener"s
syndrome; two cases in siblings. CT abdomen axial section; showing transposition of viscerae (spleen in the right side and liver in the left side).
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Kartagener"s
syndrome; two cases in siblings. CT abdomen axial section; shows right-sided spleen and left-sided spleen and stomach, suggesting Situs Inversus.
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Incidentally
detected Kartagener"s syndrome. Cardiac apex, descending aorta on the right side. (dextrocardia)
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Incidentally
detected Kartagener"s syndrome. Axial CT (mediastinal window): Descending aorta (AO) on the right and inferior vena cava (IVC) on the left with dextrocardia (situs inversus thoracalis).
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Incidentally
detected Kartagener"s syndrome. Axial CT (lung window) showing left middle lobe minimal bronchiectasis.
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Incidentally
detected Kartagener"s syndrome. Axial MIP (maximum intensity projection) CT scan showing centrilobular nodules with tree-in-bud pattern in bilateral lower lobes.
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Incidentally
detected Kartagener"s syndrome. Situs inversus abdominalis: note the total transposition of abdominal viscera: liver, IVC on the left side; spleen, gastric fundus, aorta on the right side (i.e. mirror image of internal organs normal positioning).
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Incidentally
detected Kartagener"s syndrome. Situs inversus totalis
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Incidentally
detected Kartagener"s syndrome. Axial CT (mediastinal window): Note right-sided aortic arch (arrow) (situs inversus thoracalis)
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Situs
inversus with dextrocardia. Anterior posterior supine position shows reversed position of colonic frame as descending colon is in the right lower abdomen, splenic flexure in the right upper and hepatic flexure in the left upper abdomen.
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Situs
inversus with dextrocardia. Chest X-ray demonstrates right side position of heart (dextroacardia) with reversed position of abdominal organs, liver in the left side of the abdomen and stomach in the right side of the abdomen.
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Radiopaedia • CC-by-nc-sa 3.0 • de

Situs inversus, (rare plural: sitūs inversi) short form of the Latin “situs inversus viscerum”, is a term used to describe the inverted position of chest and abdominal organs. It is called situs inversus totalis when there is a total transposition of abdominal and thoracic viscera (mirror image of internal organs normal positioning). Normal positioning of the organs - as found in the majority of individuals is called situs solitus.

Pathology

Associations

Situs inversus is usually associated with dextrocardia (true mirror image) with only 3-5% incidence of congenital heart disease, most commonly transposition of the great vessels. Of these patients, 80% have a right-sided aortic arch. Situs inversus with levocardia (which is much rarer: 0.00005%) congenital heart disease is found in 95% of patients .

Up to 20% of patients with situs inversus can have Kartagener syndrome  which comprises a subgroup of primary ciliary dyskinesia.

Radiographic features

Imaging features on chest radiograph to be evaluated are:

  • location of heart apex
  • location of aortic arch
  • locations of stomach bubble and liver

See also

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Situs inversus:
rechts
descendierende Aorta
Wikipedia • CC BY-SA 4.0
Transposition
der großen Arterien
Wikipedia • CC0
Kartagener-Syndrom
 
Wikipedia • Public domain
primäre
ciliäre Dyskinesie
Wikipedia • Public domain
Situs
inversus totalis
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