Situs inversus totalis in an asymptomatic adolescent - importance of patient education: A case report

Abstract

BACKGROUND

Situs inversus totalis (SIT) may be an incidental finding in asymptomatic children. Patients may not understand the implications of this condition and the importance of relaying the diagnosis to their healthcare providers.

CASE SUMMARY

We report an asymptomatic seventeen-year-old adolescent with previously-diagnosed SIT who presented for a routine well-child visit. During history taking, he denied any past medical conditions, including cardiovascular conditions. Only when physical exam revealed point of maximal impulse and heart sounds on the right side, did he convey that he had been diagnosed with SIT incidentally at age of 12 years. He was not aware of associated conditions or the potential implications of his diagnosis, nor did he realize it is pertinent medical history to be relayed to healthcare providers. Chest X-ray confirmed dextrocardia and abdominal X-ray showed right-sided stomach. Abdomen sonogram showed left-sided liver and right-sided spleen. Echocardiogram showed normal valvular structure and function. A comprehensive discussion was provided to address the patient’s lack of understanding that SIT is a medical diagnosis with potential implications.

CONCLUSION

While SIT is rare and mostly asymptomatic, affected patients may not comprehend the importance of the diagnosis and its potential ramifications. Recognition of the patient’s lack of awareness allows the healthcare provider to educate the patient and hopefully can prevent potential medical and surgical complications.

Keywords: Situs inversus; Dextrocardia; Adolescent; Education; Case report

Core Tip: Situs inversus totalis (SIT) is a rare and mostly asymptomatic condition. This care report describes a previously-diagnosed seventeen-year-old adolescent who presented for a routine healthcare visit. During history taking, he denied any past medical conditions, including cardiovascular issues, until physical exam showed heart sounds on the right. He then revealed that he had been diagnosed with SIT incidentally at age 12, but did not realize that it is a significant condition. Patients with SIT may not understand the importance of the diagnosis and its potential ramifications. Healthcare workers must recognize that this lack of understanding of their diagnosis exists and educate them. Our patient was counseled that his diagnosis, although asymptomatic, should be relayed to healthcare teams.