Situs Inversus: A Review of 191 Published Cases

Abstract

Background: Situs inversus is a rare congenital disorder that causes a reversal in the anatomical arrangement of chest and abdominal organs, such that the organs are mirror images of the normal anatomy. It is generally classified into three: situs inversus totalis, situs abdominis (with levocardia), and situs ambiguous. Although many patients with situs inversus do go on to live normal uneventful lives, several cardiovascular, gastrointestinal as well multisystemic comorbidities have been shown to be associated with the condition. The aim of the study is to analyse and give an overview of the proportion of the different types of situs inversus and the common major comorbidities at presentation (both acquired and congenital) including the age and sex predilection, as well as the proportion of the different diagnostic methods for situs inversus. Method: Published cases from English medical journals were evaluated and analysed. Results: 191 published cases on situs inversus were reviewed. Situs inversus totalis had the highest proportion (82.7%) compared to situs ambiguous (13.6%) and situs inversus abdominis (with levocardia) (3.7%). There was no sex predilection, with a male to female ratio of 0.96 (P = 0.83). According to our study, the commonest comorbidity patients with situs inversus presented with were cholelithiasis (13.6%) and Kartagener syndrome (9.4%). Presenting comorbidities with digestive system affectation had the highest proportion (57.1%). Conclusion: The study established a significant association between acquired digestive system comorbidities like cholelithiasis, compared to other comorbidities.