scholarly journals Pipeline embolization device implantation in large carotid cavernous aneurysm associated with situs inversus totalis

2019 ◽  
Vol 25 (4) ◽  
pp. 434-437
Author(s):  
Sudheer Chakravarthi ◽  
Hidenori Oishi ◽  
Kenji Yatomi ◽  
Kohsuke Teranishi
Keyword(s):  
Situs Inversus ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Endovascular Management ◽  
Normal Position ◽  
Radiological Findings ◽  
Vascular Abnormalities ◽  
Device Implantation ◽  
Bilateral Carotid ◽  
Situs Solitus

Situs anomalies are a heterogenous class of inborn visceral and vascular abnormalities with a broad range of radiographic characteristics. Situs inversus totalis is characterized by mirror image location of the heart and viscera relative to situs solitus (normal position). Few aberrations involving the neuraxis, and rarely intracranial aneurysms, have been reported in association with situs inversus totalis. We describe the radiological findings and endovascular management of one of the first of its kind: the association of bilateral carotid cavernous aneurysms (one large and the other small-sized) with situs inversus totalis.

Situs Inversus Totalis

2001 ◽  
Vol 20 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Janie Spoon
Keyword(s):  
Situs Inversus ◽  
Vena Cava ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
The Body ◽  
Radiographic Examination ◽  
Internal Organs ◽  
Radiographic Findings ◽  
Situs Solitus ◽  
The Right

EXTERNALLY, THE HUMAN BODY appears symmetric; if a line is drawn down the middle of the body, each side appears identical. However, this is not true of the internal anatomy. For example, there is one heart, which lies in the left chest, one liver, in the right abdomen, and one stomach, in the left abdomen. The term situs refers to the position or location of an organ, specifically, the position of the atria and abdominal viscera in relation to the midline of the body.1 There are three types of situs: solitus, inversus, and ambiguous. Situs solitus refers to the normal arrangement of organs, with the right atrium, liver, gallbladder, trilobed lung, and inferior vena cava on the right side and the left atrium, stomach, spleen, bilobed lung, and descending aorta on the left side (Figures 1–3). Situs inversus totalis refers to a mirror image reversal of the normal position of the internal organs (Figures 4 and 5). 1 The incidence of situs inversus totalis is 1 in every 8,000 to 25,000 births, and the condition is most often diagnosed by radiographic examination.2Situs ambiguous, often referred to as heterotaxia, is the random arrangement of the internal organs and is associated with splenic abnormalities and congenital heart disease.3 The purpose of this column is to discuss the embryology, pathophysiology, and diagnosis of situs inversus totalis and to review a case study with radiographic findings.

scholarly journals Laparoscopic Sigmoidectomy for a Patient With Situs Inversus Totalis: Effect of Changing Operator Position

2015 ◽  
Vol 100 (4) ◽  
pp. 638-642 ◽  
Author(s):  
Mizunori Yaegashi ◽  
Toshimoto Kimura ◽  
Takashi Sakamoto ◽  
Tadao Sato ◽  
Yuichiro Kawasaki ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Situs Inversus ◽  
Operating Time ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Laparoscopic Sigmoidectomy ◽  
Vascular Abnormalities ◽  
Congenital Condition ◽  
Well Differentiated ◽  
The Right

Situs inversus totalis (SIT) is a rare congenital condition in which the abdominal and thoracic organs are on the opposite sides to their normal anatomic positions. Reports of laparoscopic surgery for colorectal cancer with SIT are very few. Due to the mirror-image transposition of organs and vascular abnormalities, laparoscopic surgery for patients with SIT is technically complicated. Therefore, it has been reported as easier for left-handed surgeons. This report presents that operative procedures can be conducted as usual by changing the positions of the operator and assistants, even if the operator is right-handed. A 71-year-old woman visited our hospital with a 2-month history of hematochezia. Colonoscopy revealed an ulcerative tumor in the sigmoid colon and biopsy confirmed well-differentiated adenocarcinoma. Laparoscopic sigmoidectomy radical lymphadenectomy was performed. The operating time was 189 minutes and blood loss was 13 mL. The patient was discharged on postoperative day 7, without any complications. We report that complicated surgical procedures for patients with SIT can be simplified by changing viewpoints. Due to the altered anatomy in SIT, the positions of the operator and assistants are very important. Location of the pelvis is almost the same as in orthotopic patients, by moving the operator from the left side to the right side of the patient. Changing the position of the operator to the right side seems to be effective for patients with SIT during pelvic procedures.

scholarly journals Situs Inversus Totalis: A Rare Congenital Anomaly and the Presence of COPD Giving a Concept of Dextroposition with Limb Lead Reversal in ECG

2017 ◽  
Vol 31 (2) ◽  
pp. 100-103
Author(s):  
Khandker Md. Nurus Sabah ◽  
Abdul Wadud Chowdhury ◽  
Mohammad Shahidul Islam ◽  
Mohammad Gaffar Amin ◽  
Md Azizul Hassan Khandakar ◽  
...  
Keyword(s):  
Situs Inversus ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Medical Attention ◽  
Chronic Obstructive ◽  
Medical Illness ◽  
Normal Position ◽  
Obstructive Pulmonary Disease ◽  
Points Of View ◽  
Thoracic And Abdominal

Situs inversus totalis is the mirror-image of normal position of the thoracic and abdominal viscera. It may be detected incidentally when the patient seek medical attention for other medical illness. From medico-legal points of view, this rare disorder is important in many ways for a junior physician to prevent a big mishap, especially surgical. Here, we report a case, who was 55- year-old, seeking medical attention for infective exacerbation of chronic obstructive pulmonary disease incidentally diagnosed as a case of situs inversus totalis.Bangladesh Heart Journal 2016; 31(2) : 100-103

Abstract 485: A Mouse Model of Primary Ciliary Dyskinesia Reveals High Frequencies of Heterotaxy and Complex Congenital Heart Defects

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Serena Y Tan ◽  
Linda Leatherbury ◽  
Julie Rosenthal ◽  
Xiao-Qing Zhao ◽  
Cecilia W Lo
Keyword(s):  
Situs Inversus ◽  
Primary Ciliary Dyskinesia ◽  
Congenital Heart ◽  
Heart Defects ◽  
Vena Cava ◽  
Situs Inversus Totalis ◽  
Complex Congenital Heart Disease ◽  
Ciliary Function ◽  
Situs Solitus ◽  
Ciliary Dyskinesia

Specification of left-right asymmetry is essential for formation of the four chamber heart and separate systemic and pulmonary circulation. Previous studies suggest monocilia at the embryonic node is required for left-right patterning. This patterning is perturbed in primary ciliary dyskinesia (PCD) where situs defects and bronchiectasis are observed, often due to ciliary dysfunction arising from dynein mutations. Most PCD patients exhibit situs solitus or situs inversus totalis, but heterotaxy with complex congenital heart disease (CHD) appears to be rare, reported as 6%. We recovered a mouse mutation in dynein Mdnah5 that disrupts ciliary function. Homozygote mutants exhibit situs phenotypes consistent with PCD in humans. To assess the frequency of CHD associated with PCD, we harvested16 litters of embryos. All wildtype and heterozygous offspring (89) showed normal body situs. Of the 21 (19%) homozygous mutants obtained, 6 had situs solitus, 7 situs inversus and 8 heterotaxy, with heterotaxy being any situs deviation in the cardiac, pulmonary or visceral anatomy. Of the heterotaxic embryos, 3 had levo and 5 dextrocardia. Histology and 3D reconstruction showed 7 of the heterotaxy embryos had complex CHD, which included atrial isomerism, superior-inferior ventricles (Figure ), malposition of the great arteries, AV cushion defects, and azygous continuation of the inferior vena cava. These results show a much higher frequency of heterotaxy and complex CHD than previously reported for PCD (38% vs. 6%), suggesting PCD patients should be screened for CHD. The high incidence of CHD associated with PCD indicates ciliary function may have other roles in cardiovascular patterning.

scholarly journals Specificities of transplantation of kidneys procured from donors with situs inversus totalis: A case report and review of the literature

2015 ◽  
Vol 72 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Milica Petrovic ◽  
Violeta Rabrenovic ◽  
Dusica Stamenkovic ◽  
Neven Vavic ◽  
Zoran Kovacevic ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Case Report ◽  
Situs Inversus ◽  
Iliac Fossa ◽  
Preoperative Evaluation ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Image Reversal ◽  
The Right

Introduction. Situs inversus totalis (SIT) represents a total vertical transposition of the thoracic and abdominal organs which are arranged in a mirror image reversal of the normal positioning 1. We presented a successful pre-dialysis kidney transplantation from a living sibling donor with SIT and the longest donor follow-up period, along with analysis of the reviewed literature. Case report. The pair for pre-dialysis kidney transplantation included a 68-year-old mother and 34-year-old daughter at low immunological risk. Comorbidities evidenced in kidney donors with previously diagnosed SIT, included moderate arterial hypertension and borderline blood glucose level. Explantation of the left donor kidney and its placement into the right iliac fossa of the recipient were performed in the course of the surgical procedure. A month after nephrectomy, second degree renal failure was noticed in the donor. A 20-month follow-up of the donor?s kidney and graft in the recipient proved that their functions were excellent. Conclusion. In donors with previously diagnosed SIT the multidisciplinary approach, preoperative evaluation of the patient and detection of possible vascular anomalies are required to provide maximum safety for the donor.

Structure and torsion of the normal and situs inversus totalis cardiac left ventricle. I. Experimental data in humans

2008 ◽  
Vol 295 (1) ◽  
pp. H197-H201 ◽  
Author(s):  
Tammo Delhaas ◽  
Wilco Kroon ◽  
Wim Decaluwe ◽  
Mirjam Rubbens ◽  
Peter Bovendeerd ◽  
...  
Keyword(s):  
Situs Inversus ◽  
Mechanical Load ◽  
Normal Structure ◽  
Companion Paper ◽  
Situs Inversus Totalis ◽  
Left Ventricular ◽  
Mirror Image ◽  
Anatomical Structures ◽  
Magnetic Resonance Tagging ◽  
Cardiac Left Ventricle

In 1926, the famous American pediatric cardiologist, Dr. Helen B. Taussig, observed that in situs inversus totalis (SIT) main gross anatomical structures and the deep muscle bundles of the ventricles were a mirror image of the normal structure, while the direction of the superficial muscle bundles remained unchanged (H. B. Taussig, Bull Johns Hopkins Hosp 39: 199–202, 1926). She and we wondered about the implication of this observation for left ventricular (LV) deformation in SIT. We used magnetic resonance tagging to obtain information on LV deformation, rotation, and torsion from a series of tagged images in five evenly distributed, parallel, short-axis sections of the heart of nine controls and eight persons with SIT without other structural (cardiac) defect. In the controls, during ejection, the apex rotated counterclockwise with respect to the base, when looking from the apex. Furthermore, the base-to-apex gradient in rotation (torsion) was negative and similar at all longitudinal levels of the LV. In SIT hearts, torsion was positive near the base, indicating mirrored myofiber orientations compared with the normal LV. Contrary to expectations, torsion in the apical regions of SIT LVs was as in normal ones, reflecting a normal internal myocardial architecture. The transition zone with zero torsion, found between the apex and base, suggests that the heart structure in SIT is essentially different from that in the normal heart. This provides a unique possibility to study regulatory mechanisms for myocardial fiber orientation and mechanical load, which has been dealt with in the companion paper by Kroon et al.

scholarly journals Emergency mitral valve replacement in dextrocardia with situs inversus totalis: Surgeon's dilemma of mirror image

2021 ◽  
Vol 5 (1) ◽  
pp. 19
Author(s):  
Anshuman Darbari ◽  
Devender Singh ◽  
PrashantL Patil ◽  
Barun Kumar
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Situs Inversus ◽  
Situs Inversus Totalis ◽  
Mirror Image

scholarly journals Right Hemihepatectomy via an Anterior Approach for Hepatocellular Carcinoma in a Situs Inversus Totalis Patient

2020 ◽  
Vol 14 (1) ◽  
pp. 91-97
Author(s):  
Rong-Dang Fu ◽  
Jie-Yuan Li ◽  
Xiao-Hong Zhang ◽  
Huan-Wei Chen
Keyword(s):  
Hepatocellular Carcinoma ◽  
Situs Inversus ◽  
Anterior Approach ◽  
Middle Hepatic Vein ◽  
Situs Inversus Totalis ◽  
Mirror Image ◽  
Right Hemihepatectomy ◽  
Glissonian Approach ◽  
Congenital Condition ◽  
Chest X Ray

Situs inversus totalis (SIT) is a rare congenital condition in which the usual position of the organs is reversed from left to right as a mirror image of the normal situation. Due to the abnormal transposition, this represents a technical challenge for the surgeon. In the present study, right hemihepatectomy via the anterior approach was performed for a 68-year-old hepatocellular carcinoma (HCC) patient with SIT. SIT was diagnosed by chest X-ray and computed tomography. The tumors were located in segments VIII and VI of the liver, and there was no metastasis to the lymph nodes and distant organs. Hemihepatic vascular inflow occlusion was performed using the selective intra-Glissonian approach. The middle hepatic vein was preserved under the guidance with intraoperative ultrasonography. The present case suggests that right hemihepatectomy via the anterior approach may be a safe, feasible, and effective procedure for HCC patients with SIT.

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