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At least 19 recordsLinked to original sources
PubMed2001

Liver transplantation from situs inversus to situs inversus.

Congenital anatomic anomalies often present technical obstacles during liver transplantation. Biliary atresia (BA) is the most common indication for liver transplantation in children, and up to 28% of children with situs inversus are complicated by BA. A boy aged 2 years 11 months with BA, situs inversus, and dextrocardia received a liver transplant from his father. The donor also had situs inversus and dextrocardia without other anomalies. Graft function was excellent postoperatively, and no significant complications were encountered. This is only the second report of the successful use of a living related donor graft for a patient with BA and situs inversus. This case was particularly rare because the donor also had situs inversus, which made the present procedure more feasible.

Adult↗
PubMed2005

Living donor liver transplantation using a right lobe graft in an adult with situs inversus.

Situs inversus totalis is a rare anatomic variant in which there is a complete mirror image of the thoracic and abdominal viscera. The common association of situs inversus and biliary atresia has led to a variety of modifications of surgical techniques utilizing both living donor and deceased donor liver grafts, with mixed results in the pediatric liver transplant population. The use of a living donor liver graft in an adult with situs inversus has not yet been described. However, living donor liver transplantation (LDLT) has produced excellent results in the adult population, particularly in the cholestatic population, which may be disadvantaged by the model for end-stage liver disease system. This is the first report of a successful living donor right liver graft in an adult with end-stage liver disease secondary to primary sclerosing cholangitis and situs inversus totalis.

Anastomosis, Surgical↗
PubMed1994

Single-lung transplantation in situs inversus.

Situs inversus totalis is a rare anatomic condition characterized by the mirror-imaged arrangement of asymmetric thoracic and abdominal organs. Although associated cardiopulmonary disease is uncommon, end-stage lung disease can develop in patients with situs inversus, necessitating transplantation. In this report, we describe a 30-year-old patient with situs inversus totalis and end-stage pulmonary hypertension who underwent successful orthotopic left lung transplantation.

Adult↗
PubMed1992

Laparoscopic cholecystectomy and ERCP with sphincterotomy in an elderly patient with situs inversus.

Situs inversus viscerum (transposition of the viscera) is a rare condition with a genetic predisposition that is autosomal recessive. We present a patient with situs inversus, cholelithiasis, and choledocholithiasis who was successfully treated via laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography with sphincterotomy. This paper further expands the application of these techniques and shows that they can be safely and effectively applied in the setting of situs inversus, although attention must be paid to the details of left-right reversal.

Aged↗
PubMed1993

Liver transplantation in patients with situs inversus.

Situs inversus has been considered an absolute contraindication to liver transplantation due to technical difficulties. Associated vascular malformation and distorted anatomy may make the procedure even more complicated or impossible. Only three cases of patients with abdominal situs inversus who underwent successful liver transplantation have been reported in the English literature. We describe two additional patients with situs inversus who suffered from biliary atresia and underwent successful liver transplantation. The preoperative evaluation and the operative procedure are presented, and technical difficulties are discussed. Since biliary atresia is associated with polysplenia syndrome, including vascular malformation and visceral malposition, we suggest that each case be extensively evaluated preoperatively to determine the size requirement for the donor liver and the feasibility of reconstruction.

Biliary Atresia↗
PubMed2001

Coronary stent deployment in situs inversus.

Situs inversus with dextrocardia occurs in approximately one in 10 000 patients. Successful stent deployment for the treatment of unstable angina and situs inversus is presented. Three technical challenges associated with the procedure are highlighted. Firstly, the successful choice of diagnostic and interventional catheters is based on an understanding of the orientation of the aortic arch. With a right sided aorta Judkins catheters should be successful. Secondly, image reversal is not necessarily required for image interpretation. Thirdly, successful coronary engagement with catheters requires rotation in a direction opposite to that normally used.

Aged↗
PubMed1998

Orthotopic liver transplantation in patients with biliary atresia and situs inversus.

Situs inversus (SI) and the polysplenia syndrome (PS) occur relatively frequently in patients with biliary atresia, the largest subgroup of pediatric liver transplantation patients. We present two cases of orthotopic liver transplantation (OLT) in pediatric patients with SI. One had SI totalis, where a normal liver was placed in the left upper quadrant (LUQ) with the right lobe overlying the vertebral column. The second had PS and isolated SI of the liver, and a living-related left-lateral-segment graft was placed in the LUQ. Although multiple, often unpredictable vascular and intestinal anomalies occur frequently in association with SI, particularly in the setting of the PS, these cases, as well as several others recently reported, reveal that these anomalies can be managed successfully by a variety of technical modifications of the standard OLT technique. Likewise, concerns about the placement of a situs solitus liver in the midline or LUQ position of a SI abdomen have proved to be unfounded.

Biliary Atresia↗
PubMed2006

Case report: Placement of a coronary sinus lead in a patient with dextrocardia and situs inversus.

Situs inversus with dextrocardia is a congenital condition in which the heart is a mirror image of the anatomically normal heart on the right side. Patients with this condition are increasingly surviving into adulthood and may present with heart failure. Several of such patients may benefit from atriobiventricular pacing which may be technically challenging. This case report describes techniques and equipment used to successfully place a coronary sinus lead in a patient with this congenital condition.

Dextrocardia↗
PubMed2006

Laparoscopic sleeve gastrectomy for a super-super-obese patient with situs inversus totalis.

Situs inversus totalis is a rare defect which can present difficulties in the management in laparoscopic surgery due to the mirror-image anatomy. Herein, we report a patient with situs inversus totalis and super-super-obesity (BMI 76 kg/m2). We performed successful laparoscopic sleeve gastrectomy. Technical details of this operation, with situs inversus totalis, are presented. There were no major difficulties compared to patients with usual anatomy. There are potential diseases associated with situs inversus and obesity; therefore, a careful investigation, including a chest x-ray and cardiac and abdominal ultrasounds should be performed before surgery. Sleeve gastrectomy is an adequate procedure in super-super-obese patients with situs inversus totalis.

Adult↗
PubMed2003

A case of complete situs inversus.

Complete situs inversus is a rare syndrome, with overall frequency estimated at 1/10,000 births, resulting from abnormal rotation of the cardiac tube during embryogenesis, of unknown mechanism. Recent studies suggest that left-right asymmetry defects are likely to be due to genetic abnormalities in the lefty, nodal, i.v., HAND, ZIC3, Shh, ACVR2B and/or Pitxz genes. In dextrocardia with situs inversus the heart is structurally normal in 90-95% of cases, in contrast to dextroversion (dextrocardia with situs solitus), which has a high incidence of structural cardiac defects. Atrial septal defect is one of the most common congenital cardiac anomalies in adults. Diagnosis is based on clinical manifestations and simple complementary diagnostic exams like abdominal and thoracic radiography and electrocardiogram. Prognosis in isolated dextrocardia depends on the congenital cardiac defects present. By contrast, in dextrocardia with situs inversus life expectancy is similar to that of the general population. The authors present the case of a 64-year-old German man admitted to the emergency care unit with a diagnosis of embolic stroke due to atrial fibrillation with fast ventricular rate. As clinical history could not be assessed due to language limitations, routine admission tests were performed. They revealed complete situs inversus with corrected ostium secundum atrial septal defect. Finally, the anatomic, pathologic, embryologic and etiologic features of complete situs inversus and related abnormalities of the cardiac structures are presented. Special emphasis is given to genetic abnormalities, the study of which has seen great advances since the 1990s thanks to new techniques of DNA analysis.

Dextrocardia↗
PubMed2006

Lung resection for primary bronchial carcinoma in a patient with complete situs inversus.

Complete situs inversus is a rare syndrome with a frequency estimated at 1-2/10,000 births. Situs inversus may go unrecognized until discovery during emergency surgery or investigation of symptoms. We present a case of confirmed adenocarcinoma of the left lung, treated by upper lobectomy. The computed tomography (CT) scan of the thorax showed a mirror-image of the organs and vessels, confirmed by aortography and pneumoangiography. The heart was structurally normal. Abdominal CT scan showed a mirror-image of the abdominal organs. At thoracotomy, the gross appearance of the left lung and the arrangement of the pulmonary vessels and the bronchi corresponded to that normally found on the right side. Preoperative diagnosis of situs inversus in patients undergoing surgical treatment is important for operative technique and prevention of vessel injury. Preoperative angiographic examination is mandatory in patients with situs inversus undergoing lung resection.

Adenocarcinoma↗
PubMed2006

Abdominal aortic aneurysm in situs inversus totalis.

Situs inversus totalis refers to a mirror-image reversal of the normal position of the internal organs. The recognition of concomitant anomalies, such as in the cardiac, venous, gastrointestinal, and urinary systems, is extremely important because these anomalies may disturb the surgical procedure for the concurrent disease in situs inversus totalis. The authors describe a case of successfully repaired abdominal aortic aneurysm with a false aneurysm of the right external iliac artery in situs inversus totalis. The coexistence of abdominal aortic aneurysm has been seldom encountered. The presence of anatomical anomalies significantly increases operative risk. The surgical management of patients with abdominal aortic aneurysm in situs inversus totalis is discussed.

Aged↗
PubMed2003

Intracranial anatomic asymmetry in situs inversus totalis.

Situs inversus is a rare condition in which the position of the thoracic and the abdominal viscera are exchanged from the left to the right sides. A possible inversion of normal dominant intracranial anatomy, has however, rarely been discussed. We examine here the gross anatomy of an elderly cadaveric female for a possible "situs inversus" of the intracranial contents. This study has found that many structures commonly dominant on one side in the intracranial compartment were reversed in this specimen. These findings support the concept that a reversal of more commonly found intracranial anatomy may occur in situs inversus totalis, and this should alert the clinician performing invasive procedures in this population. These data will also hopefully provide further insight into possible mechanisms that contribute to situs inversus totalis.

Aged↗
PubMedDate not supplied

Prescreen evaluation of situs inversus patients.

Situs inversus is a congenital visceral malrotation anomaly that occurs in approximately 2 per 10,000 live births, but it may go unrecognized until discovered during emergency surgery. The differential diagnosis in situs inversus patients may not be readily seen in the emergency setting. Historical symptoms include reversed locations for common physical complaints, whereas physical signs can be used to diagnose and treat these patients. Laboratory data may also be used to diagnose and treat patients with this anomaly. This study was prompted by a postmortem investigation of a patient with situs inversus and dextrocardia. Several other cases of congenital malrotation, with attention to anatomical variants coupled with medical data, provide guidelines in prescreen evaluation and medical/surgical treatment of similar patients. Careful attention to laboratory and radiologic findings are paramount to quality patient care and prevention of complications. Educating these patients about their malrotation would also aid in future treatment.

Aged↗
PubMed2004

Laparoscopic surgery in situs inversus: a literature review and a report of laparoscopic sigmoidectomy for diverticulitis in situs inversus.

BACKGROUND: Situs inversus (SI) is a rare autosomal recessive congenital defect in which the position of abdominal and/or thoracic organs is a "mirror image" of the normal one, in the sagittal plain. In 25% of these cases, SI is part of the Kartagener syndrome, together with bronchiectasis and chronic sinusitis. METHODS: We present a case of a patient with Kartagener syndrome and complete SI that was laparoscopically operated on for diverticulitis. We also review the published English information available on this rare condition. RESULTS: A review of the literature revealed another single case of laparoscopic sigmoidectomy and 27 cases of other laparoscopic interventions in the presence of SI. Those laparoscopic procedures included basic procedures such as explorations and cholecystectomies, as well as advanced procedures such as gastrectomy and gastric bypass. CONCLUSION: The laparoscopic approach is feasible in cases of SI, although technically more complicated because of the different position of the organs and the different laparoscopic view of the anatomy.

Adult↗