No abstract available.
Situs Inversus*

Situs inversus totalis is a very rare anatomical abnormality, which is characterized by dextrocardia and "mirror image" distribution of abdominal organs. Dextrocardia and situs inversus have important surgical implications due to altered anatomy. The aim of this study was to describe the anatomical structures of the situs inversus with dextrocardia in Korean. Presence of situs inversus with dextrocardia was confirmed in a 72-year-old female cadaver during dissection in a gross anatomy course. It was observed by focusing on the positions of the thoracoabdominal structures. In this cadaver, clearly inverted morpholoiges existed in the structures of the thoracoabdomen except the kidneys. The left-sided kidney was located at a slightly higher level than the right-sided kidney although the liver was located on the left side. We reported herein a case of dextrocardia and situs inversus with incomplete inversion, which will provide useful information for accurate diagnosis and relevant surgical procedures.
Aged ; Cadaver ; Dextrocardia* ; Diagnosis ; Female ; Humans ; Kidney ; Liver ; Situs Inversus*

Ischemic heart disease is a common complication of thyrotoxicosis, although the exact mechanism has not been defined. In patient with dextrocardia as a part of situs inversus, coronary heart disease may occur with similar frequency and manifestation as in the general population. A case is reported of angina and thyrotoxicosis in patient with situs inversus totalis in which the angina was manifested by ST-segment elevation during graded exercise, relieved by antithyroid treatment. This unusual case establishes an association between hyperthy-roidism and ischemic heart disease.
Coronary Disease ; Dextrocardia ; Humans ; Hyperthyroidism* ; Myocardial Ischemia ; Situs Inversus* ; Thyrotoxicosis

The corrected transposition of the great arteries is an usual congenital cardiac malformation, which consisitsof transposition of great arteries and ventricular inversion, and which is caused by abnormal developement ofconotruncus and ventricular looping. High frequency of associated cardiac malformations makes it difficult to getaccurate morphologic diagnosis. A total of 18 cases of corrected transposition of the great arteries is presented,in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul NationalUniversity Hospital between Sep. 1976 and June 1981. The clinical, radiogrpahic ,and operative findings with theemphasis on the angiocardiographic findings were analized. The resuls are as follows; 1. Among 18 cases, 13 caseshave normal cardiac position, 2 cases have dextrocardia with situs solitus, 2 cases have dextrocardia with situsinversus and 1 case has levocardia with situs inversus. 2. Segmental sets are {S.L.L.} in 15 cases, and {I.D.D} in3 cases and there is no exception to loop rule. 3. Side by side interrelationships of both ventricles and bothsemilunar valves are noticed in 10 and 12 cases respectively. 4. Subaortic type conus is noted in all 18 cases. 5.Associated cardiac malformations are VSD in 14 cases, PS in 11, PDA in 3, PFO in 3, ASD in 2, right aortic arch in2, tricuspid insufficiency, mitral prolapse, persistent left SVC and persistent right SVC in 1 case respectively.6. For accurate diagnosis of corrected TGA, selective biventriculography using biplane cineradiography is anessential procedure.
Angiocardiography ; Aorta, Thoracic ; Arteries ; Cardiac Catheterization ; Cardiac Catheters ; Cineradiography ; Conus Snail ; Dextrocardia ; Diagnosis ; Levocardia ; Mitral Valve Insufficiency ; Prolapse ; Seoul ; Situs Inversus ; Transposition of Great Vessels

Complete ; Situs Inversus

Situs inversus totalis is a rare inherent disease in which the thoracic and abdominal organs are transposed. Symptoms of appendicitis in situs inversus (SI) may appear in the left lower quadrant, and the diagnosis of appendicitis is very difficult. We report a case of left-sided appendicitis diagnosed preoperatively after dextrocardia that was detected by chest X-ray, although the chief complaint of the patient was left lower-quadrant pain. The patient underwent an emergent laparoscopic appendectomy under the diagnosis of appendicitis after abdominal computed tomography (CT). In patients with left lower quadrant pain, if the chest X-ray shows dextrocardia, one should suspect left-sided appendicitis. A strong suspicion of appendicitis and an emergency laparoscopic operation after confirmation of the diagnosis by imaging modalities including abdominal CT or sonography can reduce the likelihood of misdiagnosis and complications including perforation and abscess. Laparoscopic appendectomy in SI was technically more challenging because of the mirror nature of the anatomy.
Abscess ; Appendectomy ; Appendicitis ; Dextrocardia ; Diagnostic Errors ; Emergencies ; Humans ; Situs Inversus ; Thorax

PURPOSE: The purpose of this study is to ascertain the clinical manifestations and associated cardiac anomalies of dextrocardia. METHODS: Twenty-four pediatric patients, who were admitted to, or visited, Dongsan Medical Center Keimyung University and were diagnosed with dextrocardia between January 1996 and July 2001, were enrolled in this study. All patients received echocardiogram and abdominal ultrasonogram to identify structural cardiac anomalies and visceral position. RESULTS:Among 24 patients, 7 cases were situs solitus(29.2%), 10 cases(41.6%) were situs inversus and 7 cases(29.2%) were situs ambiguous. Most were diagnosed within a week of life(87.5%). They were most commonly cyanotic(45.8%), but eleven cases(45.8%) had no specific symptoms or signs. Nineteen cases(79.2%) had accompanied cardiac anomalies, and pulmonary stenosis or atresia were the most common among them. All the cases of situs solitus and ambiguous had associated cardiac anomalies, but half of the situs inversus had that. Eleven cases were dead by cardiac or extracardiac anomalies during follow up and the mortality rate was higher in situs solitus or ambiguous group than situs inversus group. CONCLUSION: Dextrocardia accompanies different cardiac and extracardiac anomalies. It's very important to diagnose dextrocardia and associated cardiac or extracardiac anomalies in the early stages of life to improve prognosis.
Dextrocardia* ; Follow-Up Studies ; Humans ; Mortality ; Prognosis ; Pulmonary Valve Stenosis ; Situs Inversus ; Ultrasonography

A 4-year and 11-month old child was diagnosed as having dextrocardia, pulmonary atresia, atrioventricular discordance, aorta from right ventricle, PDA, the interruption of right pulmonary artery and postoperative state of Blalock-Taussig shunt on right pulmonary artery. Anatomical repair so called "double switch operation" was performed; the Ratelli procedure on ventricular level and the Mustard procedure on atrial level. We report the successful anatomical repair of congenitally Physiologically Corrected Transposition even with Dextrocardia, Situs Inversus and the interruption of Right Pulmonary Artery.
Aorta ; Child ; Dextrocardia* ; Heart Ventricles ; Humans ; Infant ; Mustard Plant ; Pulmonary Artery* ; Pulmonary Atresia ; Situs Inversus*

Two cases of Kartageneranjx syndrome were presented. They were sisters in the same family and were 15 years and 13 years old respectively. Chief complaints of the first case were chronic cough and expectoration and of the second case were chronic cough, expectoration and nasal stuffiness. Situs inversus, bronchiectasis and paranasal sinusitis were identified in both cases. EKG showed typical findings of mirror image compatible with dextrocardia in all two cases. Administration of antibiotics and postural drainage were performed with good resultin the first case but no remarkable improvement in the second case. A brief review of literatures was made.
Adolescent ; Anti-Bacterial Agents ; Bronchiectasis ; Cough ; Dextrocardia ; Drainage, Postural ; Electrocardiography ; Humans ; Siblings* ; Sinusitis ; Situs Inversus

Frequent anomalies causing a left-sided appendix are situs inversus and malrotation. The ectopic position of the appendix frequently causes a delay or error in diagnosis because of atypical symptoms. A physical examination is of limited value unless dextrocardia is present. A left-sided appendix is a rare anomaly, but when other diseases are ruled out, it must be considered especially at the emergency department.
Appendicitis* ; Appendix ; Dextrocardia ; Diagnosis ; Emergency Service, Hospital ; Physical Examination ; Situs Inversus