SITUS INVERSUS With Umbilical Hernia.A Rare Interesting Case

This is An interesting rare case, where the Heart is on right side (Dextrocardia) of chest as seen by x-ray , instead of its normal left position.
Inside abdomen, its found from CT Scan that the liver and gallbladder occupying left side of body. Spleen occupying right side of body.
The dilated stomach is situated on right side of body and pancreas lying on right side of body.
This Is an interesting case of Situs Inversus.
CT scan showing medium sized defect in anterior abdominal wall near umbilicus with omentum as content of it.

Final diagnosis is - Situs Inversus With Umbilical Hernia.

Surgery performed on this patient .
Laparoscopic Umbilical Hernioplasty performed on this patient .
Discussion -
Situs inverses is a congenital condition, where the internal body organ remains in exactly opposite site (mirror image) where they suppose to remain.
Also called situs transverses. It's a Latin word meaning inverted position of internal organs. It usually affects organs of thorax and abdomen.
The Heart occupies the right side of thoracic cavity. Right lung is bilobed and left lung become trilobed.
In the abdominal cavity liver, gallbladder remains in left side of body and stomach and spleen remains in right side of body.
It is an autosomal recessive condition.
5-10 % cases congenital heart disease is associated in situs inversus totalis.
Usually patients remain asymptomatic till they come for examination for some other condition and get investigated.
It always creates confusion regarding signs and symptoms of common diseases.
Physician has to search for heart sounds on right side of chest.
Signs of appendicitis are completely in opposite side.

A syndrome called Kartagener syndrome (primary ciliary dyskinesia) present with triad like situs inversus, chronic sinusitis, and bronchiectasis.

[roentgen]

I'm a CT tech in the USA. Very interesting case! One of my first patients after getting out of school had situs inversus. He was being examined pre-op for a gastric bypass procedure, and had no idea of his condition. Thank you for posting these cases, this is very interesting!

[DrSusmitaDas]

Definitely a Rare case....
Though read from books, But Watching this case for first time in my life...

Great Work Doctor....

[sankaqm]

Performing laparoscopic gastric bypass in a situs inversus patient is interesting as your port position changes.Dissection is in opposite direction and performing surgery on this type of patient is itself interesting as the case is rare.

[sankaqm]

Performing gastric bypass in a situs inversus case is more interesting.I think as a surgeon if any one gets a case like this to perform a gastric by pass, then no thing better than that.

[roentgen]

I don't know if the patient went ahead with the bypass. Would it be more difficult to perform the bypass on such a patient?