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Published in: Journal of Medical Case Reports 1/2014

Open Access 01-12-2014 | Case report

Dextrocardia and asplenia in situs inversus totalis in a baby: a case report

Authors: Abnish Kumar, Manoj Kumar Singh, Neeraj Yadav

Published in: Journal of Medical Case Reports | Issue 1/2014

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Abstract

Introduction

Situs inversus with dextrocardia is the complete inversion of position of the thoracic and abdominal viscera. It may be isolated or associated with malformations, especially cardiac and/or alimentary. It may be discovered in infancy because of associated anomalies but often remains asymptomatic and discovered incidentally in adult life. Only a small number of cases have been reported from India.

Case presentation

We report the case of a 7-month-old Indo-Aryan baby girl found to have dextrocardia with situs inversus totalis who presented with fever, cough and respiratory distress. A chest X-ray showed her heart in the right hemithorax with the cardiac apex pointing towards the right. The findings of an electrocardiogram and echocardiography confirmed the location of her heart in the right hemithorax and an abdominal sonogram showed her liver and gall bladder in midline of her abdomen whereas her stomach was located more towards the right side, her spleen was absent.

Conclusions

Situs inversus totalis, although a rare condition, should be sought for when clinical and radiologic findings indicate dextrocardia, especially as it may be an incidental finding. Doctors should encourage routine medical examination for their patients which could help identify this anomaly, thereby preventing wrong diagnosis and possibly death due to delay in management.
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Literature
1.
go back to reference Perloff JK: The cardiac malposition. The Clinical Recognition of Congenital Heart Disease. Fourth edition, India edition. Edited by: Perloff JK. 1998, Philadelphia: Harcourt Brace & Company Asia PTE Ltd, W B Saunders Co, 21-52. Chapter 3 Perloff JK: The cardiac malposition. The Clinical Recognition of Congenital Heart Disease. Fourth edition, India edition. Edited by: Perloff JK. 1998, Philadelphia: Harcourt Brace & Company Asia PTE Ltd, W B Saunders Co, 21-52. Chapter 3
2.
go back to reference Kulkarni PR, Inamdar VV: Situs inversus with dextrocardia associated with ventricular septal defect – a case report, Abstract. J Anat Soc India. 2005, 54 (1): Kulkarni PR, Inamdar VV: Situs inversus with dextrocardia associated with ventricular septal defect – a case report, Abstract. J Anat Soc India. 2005, 54 (1):
3.
go back to reference Madan Kumar K, Irineu , Babu C, Chander S, Kumar A, Balchander J, Nachipaan M: Complete A-V canal defect with dextrocardia with CCTGA – A case Report. IJTCVS. 2003, 19: 55- Madan Kumar K, Irineu , Babu C, Chander S, Kumar A, Balchander J, Nachipaan M: Complete A-V canal defect with dextrocardia with CCTGA – A case Report. IJTCVS. 2003, 19: 55-
4.
go back to reference Isezuo SA, Ma’aji SM, Isah U, Makusidi A: Dextrocardia with situs viscerum inversus totalis in a 65 year old man: a case report. Niger J Clin Pract. 2010, 13 (1): 98-100. Isezuo SA, Ma’aji SM, Isah U, Makusidi A: Dextrocardia with situs viscerum inversus totalis in a 65 year old man: a case report. Niger J Clin Pract. 2010, 13 (1): 98-100.
5.
go back to reference Iino K, Watanabe G, Ishikawa N, Tomita S: Total endoscopic robotic atrial septal defect repair in a patient with dextrocardia and situs inversus totalis. Interact CardioVasc Thorac Surg. 2012, 14 (4): 476-477. 10.1093/icvts/ivr103.CrossRefPubMed Iino K, Watanabe G, Ishikawa N, Tomita S: Total endoscopic robotic atrial septal defect repair in a patient with dextrocardia and situs inversus totalis. Interact CardioVasc Thorac Surg. 2012, 14 (4): 476-477. 10.1093/icvts/ivr103.CrossRefPubMed
6.
go back to reference Piryani RM, Shukla A, Prasad DN, Kohli SC, Shrestha G, Singh D: Situs inversus with dextrocardia with multiple cardiac lesions in adult. Kathmandu Univ Med J. 2007, 5 (2): 247-249. Piryani RM, Shukla A, Prasad DN, Kohli SC, Shrestha G, Singh D: Situs inversus with dextrocardia with multiple cardiac lesions in adult. Kathmandu Univ Med J. 2007, 5 (2): 247-249.
7.
go back to reference Ortega HA, Vega Nde A, Santos BQ, Maia GT: Primary ciliary dyskinesia: considerations regarding six cases of Kartagener syndrome. J Bras Pneumol. 2007, 33 (5): 602-608. 10.1590/S1806-37132007000500017.CrossRefPubMed Ortega HA, Vega Nde A, Santos BQ, Maia GT: Primary ciliary dyskinesia: considerations regarding six cases of Kartagener syndrome. J Bras Pneumol. 2007, 33 (5): 602-608. 10.1590/S1806-37132007000500017.CrossRefPubMed
8.
go back to reference Holzmann D, Ott PM, Felix H: Diagnostic approach to primary ciliary dyskinesia: a review. Eur J Pediatr. 2000, 159 (1–2): 95-98.CrossRefPubMed Holzmann D, Ott PM, Felix H: Diagnostic approach to primary ciliary dyskinesia: a review. Eur J Pediatr. 2000, 159 (1–2): 95-98.CrossRefPubMed
9.
go back to reference Kennedy MP, Omran H, Leigh MW, Dell S, Morgan L, Molina PL, Robinson BV, Minnix SL, Olbrich H, Severin T, Ahrens P, Lange L, Morillas HN, Noone PG, Zariwala MA, Knowles MR: Congenital heart disease and other heterotaxic defects in a large cohort of patients with primary ciliary dyskinesia. Circulation. 2007, 115 (22): 2814-2821. 10.1161/CIRCULATIONAHA.106.649038.CrossRefPubMed Kennedy MP, Omran H, Leigh MW, Dell S, Morgan L, Molina PL, Robinson BV, Minnix SL, Olbrich H, Severin T, Ahrens P, Lange L, Morillas HN, Noone PG, Zariwala MA, Knowles MR: Congenital heart disease and other heterotaxic defects in a large cohort of patients with primary ciliary dyskinesia. Circulation. 2007, 115 (22): 2814-2821. 10.1161/CIRCULATIONAHA.106.649038.CrossRefPubMed
10.
go back to reference Bohun CM, Potts JE, Casey BM, Sandor GG: A population-based study of cardiac malformations and outcomes associated with dextrocardia. Am J Cardiol. 2007, 100 (2): 305-309. 10.1016/j.amjcard.2007.02.095.CrossRefPubMed Bohun CM, Potts JE, Casey BM, Sandor GG: A population-based study of cardiac malformations and outcomes associated with dextrocardia. Am J Cardiol. 2007, 100 (2): 305-309. 10.1016/j.amjcard.2007.02.095.CrossRefPubMed
11.
go back to reference Merklin RJ, Varano NR: Situs inversus and cardiac defects. A study of 111 cases of reversed asymmetry. J Thoracic Cardiovasc Surg. 1963, 45: 334-342. Merklin RJ, Varano NR: Situs inversus and cardiac defects. A study of 111 cases of reversed asymmetry. J Thoracic Cardiovasc Surg. 1963, 45: 334-342.
12.
go back to reference Olbrich H, Haffner K, Kispert A, Volkel A, Volz A, Sasmez G, Reinhardt R, Hennig S, Lehrach H, Konietzko N, Zariwala M, Noone PG, Knowles M, Mitchison HM, Meeks M, Chung EM, Hildebrandt F, Sudbrak R, Omran H: Mutation in DNAH5 causes primary dyskinesia and randomisation of left-right asymmetry. Nat Gente. 2002, 30: 143-144. 10.1038/ng817.CrossRef Olbrich H, Haffner K, Kispert A, Volkel A, Volz A, Sasmez G, Reinhardt R, Hennig S, Lehrach H, Konietzko N, Zariwala M, Noone PG, Knowles M, Mitchison HM, Meeks M, Chung EM, Hildebrandt F, Sudbrak R, Omran H: Mutation in DNAH5 causes primary dyskinesia and randomisation of left-right asymmetry. Nat Gente. 2002, 30: 143-144. 10.1038/ng817.CrossRef
13.
go back to reference Agirbashi M, Hamid R, Jennings HS, Tiller GE: Situs inversus and hypertrophic cardiomyopathy in identical twins. Am J Genetics. 2000, 91: 327-330. 10.1002/(SICI)1096-8628(20000424)91:5<327::AID-AJMG1>3.0.CO;2-S.CrossRef Agirbashi M, Hamid R, Jennings HS, Tiller GE: Situs inversus and hypertrophic cardiomyopathy in identical twins. Am J Genetics. 2000, 91: 327-330. 10.1002/(SICI)1096-8628(20000424)91:5<327::AID-AJMG1>3.0.CO;2-S.CrossRef
14.
go back to reference Distefano G, Romeo MG, Grasso S, Mazonne D, Sciacca P, Mollica F: Dextrocardia with and without situs viscerum in two siblings. Am J Med. 1987, 27: 929-934. Distefano G, Romeo MG, Grasso S, Mazonne D, Sciacca P, Mollica F: Dextrocardia with and without situs viscerum in two siblings. Am J Med. 1987, 27: 929-934.
Metadata
Title
Dextrocardia and asplenia in situs inversus totalis in a baby: a case report
Authors
Abnish Kumar
Manoj Kumar Singh
Neeraj Yadav
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2014
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-8-408

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