Keywords:Situs inversus, Fetal autopsy, Dextrocardia, Agenesis, Anomalies
Situs inversus is a rare condition with a genetic predisposition, where in organs are transposed from their normal location to the opposite side of the body with an incidence of 1 in 10000 live births. If Situs Inversus is associated with other congenital anomalies the survival rate is low. So prenatal diagnosis is essential to detect any associated anomalies. During routine fetal autopsies conducted in the department of anatomy, Mysore medical college, Mysore, a rare interesting case of still born baby with gestational age of 20 weeks was observed. Autopsy findings of external examination revealed kyphosis in thoracic region. Thoracotomy revealed heart on the right side (dextrocardia). Laparotomy revealed that the left lobe of liver was bigger than the right. The gall bladder was present on the visceral surface of the left lobe of liver, stomach was on right side, duodenum on left side, pancreas and spleen were on the right side. There was agenesis of right kidney, right ureter and both suprarenal glands. All the above findings correlate with the condition situs inversus. Situs inversus is a rare condition with a genetic predisposition, it’s etiology lies in the mutation of chromosome no 12, which is critical for recognition of right sidedness.1,2 Even though there is transposition of organs in situs inversus, the survival rate is good but if situs inversus is associated with other congenital anomalies the survival rate is low. So prenatal diagnosis is essential to detect any associated anomalies to bring down mortality rate.
Annamaria Wilhelm et al. Situs inversus imaging, 2013. Available at: http://emedicine.medscape.com/article/413679-overview. Accessed 7 October 2013.
Yokoyama T, Copeland NG, Jenkins NA, Montgomery CA, Elder FF, Overbeek PA. Reversal of left-right asymmetry: a situs inversus mutation. Science. 1993;260(5108):679-82.
Sharada Sharma, Chaitanya KK, Suseelamma D. Situs inversus: an anatomical study. Anat Physiol. 2012 Dec;2(5):2-3.
Akimou Yosini, Sensaku Yosikawa, Susumu Tkrai. An autopsy case of B/L renal agenesis with situs inversus viscerum. Pathol Int. 1962;12(4):419-24.
Datta AK. Situs inversus. In: Datta AK, eds. Essentials of Human Embryology-Human Genetics. 2nd ed. India. Current Distributors; 1991: 93.
Huang SC, Chen WJ. Renal dysplasia & situs inversus totalis: an autopsy report. Chang Gung Med J. 2000 Jan;23(1):43-7.
Marta MJ, Falcão LM, Saavedra JA, Ravara L. A case of complete sinus inversus (language lateralisation). Rev Port Cardiol. 2003 Jan;22(1):91-104.