Situs inversus totalis with congenitally corrected transposition of the great arteries: insights from cardiac MRI

A Case Report of Dextrocardia with Situs Inversus: A Rare Condition and Its Clinical Importance

Situs inversus totalis (SIT) is a rare medical condition characterized by a complete mirror-image reversal of the normal positioning of the internal organs. Aristotle initially described situs inversus in animals, while Fabricius first characterized it in humans. Although the specific cause is uncertain, there is evidence of autosomal recessive and X-linked inheritance. Before seeking treatment for an unrelated ailment, many people with SIT are unaware of their distinct anatomy, as in our case. The presented case is a 30-year-old female patient from Central Ethiopia, presented to Hakim Gizaw Teaching Hospital outpatient department of medicine with the complaint of right-sided anterior chest pain for five days. Clinically, the apical beat was heard in the right 5th intercostal space. After undergoing an electrocardiogram (ECG), echocardiogram, chest X-ray, and abdominal ultrasound, she was diagnosed with situs inversus totalis. The clinical implications of SIT encompass challenges in diagnosis and procedures, potential congenital cardiac abnormalities, considerations for organ transplantation, and clinical decision-making, particularly in emergency scenarios. Key Clinical Messages. This case highlights the clinical implications of dextrocardia with situs inversus totalis, emphasizing the importance of awareness for accurate diagnosis, procedural challenges, and informed clinical decision-making. Understanding this rare condition is crucial for providing appropriate medical care and to navigate potential complications in affected individuals.

Coexistence of situs inversus totalis and hepatocellular carcinoma: A series of nine cases and a literature review

Hepatocellular carcinoma (HCC) is the most commonly diagnosed carcinoma and one of the leading causes of cancer-related deaths worldwide. Situs inversus totalis (SIT) is a congenital condition where in the internal organs of the abdomen and thorax lie in mirror images of their normal position. Thus far, there are very few reports on cases of SIT coexisting with HCC. Our case series is probably the largest series in world literature. The cohort of this retrospective study included a total of nine patients diagnosed with SIT-HCC and treated in our hospital between January 2013 and May 2018. Clinical characteristics, prognostic factors, and outcomes were summarized. Treatment strategies included surgery, transarterial chemoembolization, and microwave ablation. The diagnosis and treatment of patients with SIT are challenging because of organ reversion. The current treatment strategies for different stages of liver cancer are safe and feasible for patients with SIT-HCC.

Totally laparoscopic liver resection for colorectal metastasis located in Segment 7 in a patient with situs inversus totalis

Situs inversus totalis (SIT) is a congenital condition consisting of a mirror image of transposition of the abdominal and thoracic organs occurring in about 1:5000 to 1:10 000 adults. We report on a 60-year-old male with a single colorectal liver metastasis in the Segment 7. The patients underwent a totally laparoscopic sub-segmentectomy. Intraoperative approach on a reverse posterior segment was difficult because of left-sided position of the liver. Postoperative course was uneventful and the patient was discharged after 5 days. To our knowledge, only a few cases of open liver resections in patients with SIT have been published. This is, therefore, the first case of laparoscopic liver resection for colorectal liver metastasis in a patient with SIT. We provide the readers with useful tips to perform minimally invasive liver surgery in such patients.