A unique case of fetal situs inversus totalis with associated malformations

Abstract

Situs inversus totalis is a congenital positional anomaly characterized by transposition of abdominal and thoracic viscera. It refers to inverted position of internal organs. It can be either total or partial. Situs inversus totalis is also termed as Situs inversus with dextrocardia. Here, we are reporting autopsy findings of an anomalous male fetus of 17 weeks gestation born to a 27 years old woman who was gravida 3, para 1 and abortion 1. Prenatal ultrasound was done and was diagnosed as Situs inversus totalis associated with cleft lip and palate, short corpus callosum. After termination of pregnancy in Dept of Obstetrics and Gynecology AIMS Hospital fetus was sent to Anatomy department for autopsy. The detailed information was noted down from the case sheet of mother. The formalin was injected to cranial, thoracic and abdominal cavity. After fixation, the autopsy was done following the standard protocol. It was noted that thorax viscera were trans positioned, left lung was trilobed, right lung was bilobed and cardia on right side of thoracic cavity. The abdominal viscera were trans positioned with liver, gall bladder, caecum, appendix, ascending colon on left side and stomach, spleen, pancreas, descending and sigmoid colon on right side. Midline malformations, such as cleft lip and cleft palate were noted. Brain was not fixed well and corpus callosum could not be visualized. Situs inversus totalis is the rarest congenital anomaly. Exact etiology is unknown. Its incidence is 0.01%. Various modalities such as Ultrasonography, computed tomography can be used to diagnose situs inversus.