Situs inversus totalis occurs when there is reversal of all viscera in a mirror image of normal.
The normal positioning of organs is referred to as situs solitus.
Occurrence of situs inversus totalis: 0.01% of the population (1 in 10,000)
Inheritance:
(1) autosomal recessive
(2) X-linked
X-ray: stomach and cardiac apex on the right side
It can be asymptomatic with a normal life expectancy.
It may be associated with congenital anomalies which can impact survival.
25% of patients may have primary ciliary dyskinesia, many of which will have Kartagener’s syndrome.
A few patients may have isolated levocardia rather than dextrocardia.
Significance:
(1) appendicitis may present with left lower quadrant pain
(2) organ transplantation may be difficult due to the different orientation of the vascular supply, such as for the heart
(3) gallbladder pain is on the left side
