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Ann Ital Chir 2020 May 25;9. Epub 2020 May 25.

Introduction: Sinistroposition of the gallbladder, or true left-sided gallbladder (LSG) without situs viscerum inversus, is a rare congenital anatomical variant where the gallbladder is located to the left of round/falciform ligament. It can be associated with anomalies of the biliary tree, portal system and hepatic vascularization. The surgical management of a LSG could be challenging even for an experienced operator, being usually an incidental intraoperative finding. Read More

J Thorac Dis 2020 Apr;12(4):1588-1594

Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.

Kartagener syndrome (KS) is an autosomal recessive disorder characterized by situs inversus, paranasal sinusitis and bronchiectasis. We report the successful use of double lung transplant (DLTx) to treat end-stage KS. A 49-year-old Han woman was admitted to Renmin Hospital (Wuhan University, China) in September 2017 with a ≥15 year history of chronic productive cough that had worsened during the past year. Read More

BMC Med Genet 2020 May 1;21(1):87. Epub 2020 May 1.

Department of Medicine, Solna, Karolinska Institutet, Solnavägen 30, 171 76 Solna, Stockholm, Sweden.

Background: Developmental dyslexia (DD) is a neurodevelopmental learning disorder with high heritability. A number of candidate susceptibility genes have been identified, some of which are linked to the function of the cilium, an organelle regulating left-right asymmetry development in the embryo. Furthermore, it has been suggested that disrupted left-right asymmetry of the brain may play a role in neurodevelopmental disorders such as DD. Read More

Isr Med Assoc J 2020 Apr;22(4):260-262

Department of Pediatric B, Emek Medical Center, Afula, Israel.

Cureus 2020 Mar 25;12(3):e7407. Epub 2020 Mar 25.

Gastroenterology, West Virginia University, Morgantown, USA.

While drug-induced pancreatitis from corticosteroids has been well described in the medical literature, the exact mechanism is unclear. We present the first reported case of drug-induced pancreatitis from beta-sitosterol, a naturally occurring plant sterol structurally similar to cholesterol, obtained primarily through Western diet and supplementation. A 57-year-old male with a history of situs inversus and benign prostatic hyperplasia presented from an outside facility with a two-day history of worsening epigastric pain radiating to the right upper quadrant. Read More

Cureus 2020 Jan 30;12(1):e6822. Epub 2020 Jan 30.

Internal Medicine, Larkin Community Hospital, Hialeah, USA.

Heterotaxy syndrome (Situs ambiguus) is a condition in which the internal organs are abnormally arranged in the chest and abdomen. Individuals with this condition have complex birth defects affecting the heart, lungs, liver, spleen, intestines, and other organs. Unlike situs inversus, it often causes serious health problems. Read More

World J Clin Cases 2020 Feb;8(4):806-814

Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.

Background: Situs inversus totalis (SIT) is a rare congenital anomaly that refers to a completely reversed location of abdominal and thoracic organs. An extremely small number of patients with this condition, especially those with rectal neoplasms, have been reported. Surgery in these patients is technically challenging. Read More

Oxf Med Case Reports 2020 Feb 28;2020(2):omz135. Epub 2020 Feb 28.

Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Primary ciliary dyskinesia (PCD) is an autosomal recessive condition characterized by dysmotile cilia. Typically associated with defects in the cilia structure, it results in impaired mucociliary clearance of pathogens from the lungs and sinuses. Consequently, patients suffer from recurrent sinopulmonary and middle ear infections. Read More

BMJ Case Rep 2020 Jan 22;13(1). Epub 2020 Jan 22.

Surgery, Universitair Medisch Centrum Groningen, Groningen, Netherlands.

A 70-year-old healthy male individual offered to undergo a living donor hand-assisted laparoscopic nephrectomy to enable kidney transplantation for a close relative. As required for all living transplant donor candidates, extensive screening was performed to exclude potential contraindications for donation. Tests revealed a situs inversus totalis, meaning a complete transposition of the thoracic and abdominal organs in the sagittal plane. Read More

Einstein (Sao Paulo) 2020 10;18:eRC5111. Epub 2020 Jan 10.

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Situs inversus totalis is a rare recessive autosomal congenital abnormality in which the mediastinal and abdominal organs are in a mirrored position when compared to the usual topography. The literature reports some cases of situs inversus totalis and concomitant conditions: spinal abnormalities, cardiac malformations and hematological diseases, such as idiopathic thrombocytopenic purpura, which is an autoimmune disease that causes thrombocytopenia due to platelet destruction or suppression of its production. This article aimed to report the coexistence of situs inversus totalis and idiopathic thrombocytopenic purpura. Read More

Case Rep Radiol 2019 1;2019:7107293. Epub 2019 Dec 1.

Department of Medical Laboratory Sciences, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.

Dextrocardia with situs inversus is a rare congenital anomaly, which is characterized by right-sided heart apex and inversely rotated visceral organs of the abdomen. We report an unusual case of dextrocardia with situs inversus in a 59-year-old man, referred for a pelvic ultrasound scan because of symptoms of lower urinary tract obstruction and after a fairly normal prostate specific antigen (PSA) value. A diagnosis of enlarged prostate gland with a prominent median lobe and significant residual urine volume was made, which necessitated the examination of the kidneys for hydronephrosis, resulting in the incidental finding of situs inversus. Read More

Radiol Med 2020 Mar 10;125(3):237-246. Epub 2019 Dec 10.

Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Mansoura University Hospital, 12 El-Gomhoreya Street, Mansoura, 35112, Egypt.

Persistent left-sided superior vena cava (PLSVC) is the commonest systemic venous anomaly in the thorax with a reported prevalence of up to 0.5% in otherwise normal population and up to 10% in patients with congenital heart disease (CHD). In the absence of associated CHD, it is usually asymptomatic, discovered incidentally. Read More

Urol Case Rep 2020 Jan 20;28:101076. Epub 2019 Nov 20.

Department of Urology, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo General Medical Center, 100 High Street, Suite B280, Buffalo, NY, 14203, USA.

Situs inversus totalis (SIT) is a rare condition with left-right mirror imaging of both abdominal and thoracic organs. While this configuration is rarely of medical importance, an understanding of this unique anatomy is essential in the setting of surgical intervention. Here we review a case of renal cell carcinoma (RCC) in the setting of SIT. Read More

Prog Brain Res 2019 24;250:153-178. Epub 2019 May 24.

School of Psychology, University of Auckland, Auckland, New Zealand. Electronic address:

The human brain is often characterized in terms of a duality, with the left and right brains serving complementary functions, and even individuals are sometimes classified as either "left-brained" or "right-brained." Recent evidence from brain imaging shows that hemispheric asymmetry is multidimensional, comprised of independent lateralized circuits. Cerebral asymmetries, which include handedness, probably arise in phylogenesis through the fissioning of ancestral systems that divided and lateralized with increasing demand for specialization. Read More

Pan Afr Med J 2019 21;33:316. Epub 2019 Aug 21.

Service de Radiologie du CHU de Yopougon, Abidjan, Côte d'Ivoire.

Kartagener's syndrome is a rare primitive ciliary dyskinesia (DCP) characterized by a clinical triad: sinusitis, bronchiectasis and complete or incomplete situs inversus. It is a rare congenital autosomal recessive disease. We report a case of Kartagener syndrome in an infertile couple with akinospermia detected using spermogram. Read More

Clin Nucl Med 2019 Dec;44(12):998-1000

From the Department of Nuclear Medicine, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Science and PUMC; and Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, People's Republic of China.

A 39-year-old previously healthy woman presented possible hematuria. An ultrasound examination showed right adrenal mass and suggested pheochromocytoma. A Tc-HYNIC-TOC SPECT/CT was performed, which incidentally detected situs inversus totalis and suspicion of polysplenia without definite normal spleen in the right upper abdomen. Read More

Can J Cardiol 2019 Nov 22;35(11):1605.e1-1605.e3. Epub 2019 Aug 22.

Department of Cardiology, National University Heart Centre, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

We present a case of a 75-year-old woman with cardiac dextroposition who presented for preoperative cardiac evaluation because of exertional dyspnoea. On examination, heart sounds were best appreciated on the right, and bowel sounds were heard over the left hemithorax. Electrocardiography showed widespread T-wave inversions. Read More

J Nephrol 2020 Feb 3;33(1):183-186. Epub 2019 Oct 3.

Department of Paediatrics, Jessenius Faculty of Medicine and University Hospital, Comenius University in Bratislava, Kollarova 2, 03601, Martin, Slovakia.

Nephronophthisis, an autosomal recessive cystic kidney disease, represents genetically heterogenous group of diseases that lead to end-stage kidney disease in children and young adults. The typical clinical manifestations are polyuria, enuresis and growth failure. Left ventricular non-compaction cardiomyopathy is a rare form of cardiomyopathy, is determined by the disturbance of embryogenesis of the endocardium and myocardium. Read More

JAAPA 2019 Oct;32(10):25-28

K. Yvonne Harris is a graduate of the US Army-Baylor University doctor of science emergency medicine PA residency program and practices emergency medicine at the Eglin Air Force Base hospital in Florida. Mohamad Umar is on the faculty of the US Army-Baylor University emergency medicine PA residency program and practices emergency medicine at San Antonio Military Medical Center. The views expressed in this article are those of the authors and do not reflect the official policy or position of Brooke Army Medical Center, the US Army Medical Department, the US Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, the Department of Defense, or the US government. The authors have disclosed no potential conflicts of interest, financial or otherwise.

ST-segment elevation myocardial infarction (STEMI) is a potentially life-threatening diagnosis that cannot be missed on ECG interpretation. However, ECG interpretation may not be straightforward in patients with dextrocardia. This case report discusses the presentation of a patient with situs inversus with dextrocardia who was found to have an acute inferior MI, and how this anatomical change results in an atypical ECG and clinical presentation. Read More

Am Surg 2019 Aug;85(8):e398-e399

Am Surg 2019 Aug;85(8):e392-e393

J Assoc Physicians India 2019 Jul;67(7):72-73

Professor and Head, Department of Pulmonary Medicine, Government Medical College and Hospital, Chandigarh.

Neonatal Netw 2019 Mar 6;38(2):98-106. Epub 2019 Mar 6.

Background: VACTERL association is a sporadic, nonrandom series of congenital malformations diagnosed by the presence of three or more of the following: vertebral malformations, anal atresia, cardiac defects, tracheoesophageal fistula, renal malformations, and limb malformations. Situs inversus totalis (SIT) and esophageal malformations are rarely associated. This is the first reported case in North America of VACTERL association with SIT. Read More

BMJ Case Rep 2019 Aug 28;12(8). Epub 2019 Aug 28.

Surgical Gastroenterology, SGPGIMS, Lucknow, Uttar Pradesh, India.

Solid pseudopapillary neoplasm (SPN) in a case of situs inversus totalis (SIT) is a rare occurrence with only one case being reported until now in the literature. SIT presents a technical challenge for the operating surgeon in view of the reversed anatomy hence the operating surgeon should orient himself of the altered anatomy of SIT before contemplating surgery. To the best of our knowledge, spleen-preserving distal pancreatectomy in a patient of SPN with SIT has not been reported until now. Read More

Ann R Coll Surg Engl 2019 Nov 16;101(8):e169-e171. Epub 2019 Aug 16.

Chelsea and Westminster Hospital NHS Foundation Trust, UK.

It is well recognised that situs inversus totalis can make surgery challenging. However, partial situs inversus with heterotaxic anatomy has rarely been reported. While routine, the presence of symptomatic gallstones or cholecystitis can lead to a complex and difficult operation for such patients. Read More

J Cardiovasc Med (Hagerstown) 2019 Oct;20(10):721-724

Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy.

Ann Vasc Surg 2019 Nov 31;61:467.e7-467.e9. Epub 2019 Jul 31.

Cardiac Surgery Department, Clinica San Gaudenzio-Gruppo Policlinico of Monza, Novara, Italy.

We report a case of a 57-year-old female with dextrocardia and a solitary kidney. A patch aortoplasty for isthmic aortic coarctation repair was performed 40 years before when she was admitted to our department for dyspnea. Computed tomography scan showed a giant and saccular 10-cm diameter patch false aneurysm. Read More

J Med Genet 2019 11 31;56(11):769-777. Epub 2019 Jul 31.

Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland.

Background: Primary ciliary dyskinesia (PCD) is a motile ciliopathy, whose symptoms include airway infections, male infertility and . Apart from the typical forms of PCD, rare syndromic PCD forms exist. Mutations of the X-linked gene cause several syndromic ciliopathies, including oral-facial-digital syndrome type 1, Joubert syndrome type 10 (JBTS10), and Simpson-Golabi-Behmel syndrome type 2, the latter causing the X-linked syndromic form of PCD. Read More

Am J Cardiol 2019 09 6;124(5):820-821. Epub 2019 Jun 6.

Section of Cardiology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana. Electronic address:

A routine preoperative electrocardiogram was read by the computer as arm-lead reversal, but several features indicated that the patient had situs inversus totalis. Read More

Br J Radiol 2019 Oct 10;92(1102):20190231. Epub 2019 Jul 10.

Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India.

Viscero-atrial situs encompasses the laterality, relative position and configuration of the abdominal viscera, the atria of the heart and the tracheobronchial tree. Determining the situs and cardiac position is the first step in the commonly used sequential, segmental approach to the imaging evaluation of congenital heart defects (CHD). Abnormalities of visceroatrial situs and cardiac position are frequently associated with the presence of complex CHDs and accurate assessment of situs abnormalities can help predict the probability and type of the defect. Read More

Clin Radiol 2019 Sep 12;74(9):732.e1-732.e8. Epub 2019 Jun 12.

Department of Diagnostic and Interventional Radiology, Mansoura University, Faculty of Medicine, El-Gomhoreya Street, Mansoura, Egypt. Electronic address:

Aim: To investigate ductus arteriosus (DA) location in relation to viscero-atrial situs and branching pattern of the right aortic arch (RAA).

Materials And Methods: Computed tomography (CT) images of paediatric patients (May 2015 to July 2017, n=352) referred for evaluation of cardiovascular malformations were reviewed retrospectively. Patients with RAA were identified and images were analysed for documentation of the viscero-atrial situs, the branching pattern, DA location, and associated malformations. Read More

Brain Struct Funct 2019 Sep 13;224(7):2559-2565. Epub 2019 Jun 13.

Department of Experimental Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium.

Diffusion weighted imaging (DWI) was used to investigate white matter asymmetries in participants with situs inversus totalis (SIT) and matched controls. Regardless of visceral condition, hemispheric differences were found for the arcuate fasciculus (ARC) and the superior longitudinal fasciculus (SLF), which are involved in language and visuospatial functioning, respectively. The ARC appears lateralized to the left hemisphere, analogous to the left lateralization of functional areas associated with language. Read More

N Engl J Med 2019 Jun;380(24):e45

University of Massachusetts Medical School, Worcester, MA

Am J Case Rep 2019 Jun 8;20:806-809. Epub 2019 Jun 8.

Department of Cardiac Surgery, European Medical School Oldenburg-Groningen, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.

BACKGROUND We report a rare case of total arterial coronary artery bypass grafting (CABG) in a patient with situs inversus totalis (SIT). SIT is a rare variant of biologically normal anatomy, in which the main internal organs are mirrored compared to normal localization. CASE REPORT A 50-year-old patient with SIT and severe coronary stenosis of the left anterior descending artery (LAD) and the ramus circumflexus (RCX) was admitted to our hospital. Read More

N Z Med J 2019 06 7;132(1496):66-68. Epub 2019 Jun 7.

Consultant General Surgeon, Department of General Surgery, Wellington Regional Hospital, Wellington.

BMJ Case Rep 2019 May 28;12(5). Epub 2019 May 28.

Internal Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India.

Pulmonary agenesis is a rare developmental disorder with many syndromic associations. Type III agenesis presents with variable amounts of bronchial tree, pulmonary parenchyma and supporting vasculature. It is also reported to be associated with dextrocardia due to shifting of the heart to occupy the space left by the underdeveloped lung, which occurs as early as the fourth week of gestation. Read More

Respir Med 2019 06 30;152:105-111. Epub 2019 Apr 30.

University of Helsinki and Helsinki University Hospital, Respiratory Diseases and Allergology, Helsinki, Finland.

Background: By definition bronchiectasis (BE) means destructed structure of normal bronchus as a consequence of frequent bacterial infections and inflammation. In many senses, BE is a neglected orphan disease. A recent pan-European registry study, EMBARC, has been set up in order to better understand its pathophysiology, better phenotype patients, and to individualize their management. Read More

Intern Med 2019 Aug 22;58(16):2383-2386. Epub 2019 May 22.

First Department of Medicine Tokyo Women's Medical University, Japan.

A 33-year-old woman presented with a productive cough from childhood. She had suffered from repeated bacterial pneumonia. Her clinical and imaging findings revealed chronic sinusitis, bronchiectasis and situs inversus. Read More

J Invasive Cardiol 2019 May;31(5):E83-E88

Division of Cardiovascular Medicine, 900 South Limestone Avenue, CTW Building RM 320, Lexington, KY 40536-0200 USA.

Patients with dextrocardia present unique challenges in the catheterization laboratory. Variable coronary artery anatomy impacts percutaneous access, catheter selection and manipulation, and image acquisition. This is a review of all published reports of radial artery access for diagnostic and/or therapeutic coronary interventions in patients with dextrocardia. Read More

Medicine (Baltimore) 2019 Apr;98(17):e15211

Department of Obstetrics and Gynecology.

Rationale: Patients with situs inversus totalis (SIT) and complete atrioventricular (AV) block are extremely rare, and only few cases have been reported up to now. Due to the rarity of such condition and its anatomical complexity, we reported this case as a reference for obstetricians, providing valuable insights into potential clinical treatment.

Patient Concerns: We reported a case of 30-year-old patient with complete AV block, and her heart rate was only about 45 beats per minute. Read More

Genes Brain Behav 2019 06 23;18(5):e12572. Epub 2019 Apr 23.

Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands.

Most people have left-hemisphere dominance for various aspects of language processing, but only roughly 1% of the adult population has atypically reversed, rightward hemispheric language dominance (RHLD). The genetic-developmental program that underlies leftward language laterality is unknown, as are the causes of atypical variation. We performed an exploratory whole-genome-sequencing study, with the hypothesis that strongly penetrant, rare genetic mutations might sometimes be involved in RHLD. Read More

JACC Clin Electrophysiol 2019 Mar;5(3):404-405

Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany.

Interv Neuroradiol 2019 Aug 21;25(4):434-437. Epub 2019 Mar 21.

3 Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan.

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. Read More

J Pak Med Assoc 2019 Mar;69(3):423-425

Consultant Pediatrics Cardiologist, Shifa International Hospital, Islamabad.

Scimitar syndrome is a rare, congenital malformation. It is characterized by partial anomalous pulmonary venous connection to inferior vena cava, hypoplastic right lung along with dextroposition of the heart. Depending on the severity of the defect it can present as early as in neonatal period or incidentally later in life. Read More

Surg Laparosc Endosc Percutan Tech 2019 Jun;29(3):e29-e33

Departments of Hepatobiliary and Pancreatic Surgery.

Background: Situs inversus (SI) is a rare congenital anomaly characterized by the transposition of thoracic and abdominal viscera. Laparoscopic pancreaticoduodenectomy (LPD) is increasingly used in patients with periampullar and pancreatic carcinomas. For patients with SI, LPD can be more complicated because of reversed anatomy and possible other associated anomalies that have not been expected before surgery. Read More

Dig Liver Dis 2019 06 22;51(6):909. Epub 2019 Feb 22.

Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy.

Surgery 2020 02 18;167(2):259-263. Epub 2019 Feb 18.

Department of Surgery, University of Minnesota, Minneapolis, MN; Visible Heart Laboratories, University of Minnesota, Minneapolis, MN; Institute for Engineering in Medicine University of Minnesota, Minneapolis, MN. Electronic address:

Background: Three-dimensional printing is an additive manufacturing method that builds objects from digitally generated computational models. Core technologies behind three-dimensional printing are evolving rapidly with major advances in materials, resolution, and speed that enable greater realism and higher accuracy. These improvements have led to novel applications of these processes in the medical field. Read More

Medicine (Baltimore) 2019 Feb;98(7):e14272

Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.

Rationale: Although endoscopic and laparoscopic techniques in situs inversus totalis (SIT) have been reported respectively, endo-laparoscopic combination therapy due to biliary lithiasis remains infrequent. We shared the experience regarding the operations with a video report and discussed the similarities and differences with the usual procedures, which proved to be challenging to some extent for SIT.

Patient Concerns: Herein we present a 72-year-old man with SIT who underwent endo-laparscopic combination therapy due to choledocholithiasis and gallbladder stone. Read More

Radiol Med 2019 Jun 1;124(6):445-449. Epub 2019 Feb 1.

Department of Health Sciences (DISSAL), Radiology Section, University of Genoa, Radiologia d'Urgenza, Ospedale Policlinico San Martino IST, Largo R. Benzi, 10, 16132, Genoa, Italy.

Aim: To describe the CT findings in eight patients with left-sided inferior vena cava (IVC) in whom the left renal artery presented a precaval course (pLRA).

Materials And Methods: We searched the teaching files of six radiology departments for patients with pLRAs. Eight patients were found, and the available imaging studies and clinical histories were reviewed. Read More

Swiss Med Wkly 2019 01 13;149. Epub 2019 Jan 13.

Primary ciliary dyskinesia (PCD) is a rare, hereditary, multiorgan disease caused by defects in the structure and function of motile cilia. It results in a wide range of clinical manifestations, most commonly in the upper and lower airways. Central data collection in national and international registries is essential to studying the epidemiology of rare diseases and filling in gaps in knowledge of diseases such as PCD. Read More