Hayashi LC, Acharya R. Situs inversus totalis in an asymptomatic adolescent - importance of patient education: A case report. World J Clin Pediatr 2023; 12(5): 359-364 [PMID: 38178936 DOI: 10.5409/wjcp.v12.i5.359]
Corresponding Author of This Article
Lauren C. Hayashi, MS, Researcher, Department of Pediatrics, University of Florida College of Medicine, No. 1104 Newell Drive, Gainesville, FL 32608, United States. lauren.hayashi@ufl.edu
Research Domain of This Article
Pediatrics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Dec 9, 2023; 12(5): 359-364 Published online Dec 9, 2023. doi: 10.5409/wjcp.v12.i5.359
Situs inversus totalis in an asymptomatic adolescent - importance of patient education: A case report
Ratna Acharya, Lauren C. Hayashi
Lauren C. Hayashi, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL 32608, United States
Ratna Acharya, Division of General Pediatrics, Department of Pediatrics, University of Florida, Gainesville, FL 32608, United States
Author contributions: Hayashi LC and Acharya R were involved in the acquisition of the clinical data, analysis, writing, interpretation and revision.
Informed consent statement: Informed consent was obtained from the parent of the patient by Dr. Acharya for publication of the information.
Conflict-of-interest statement: Both authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE checklist, and the manuscript was prepared and revised according to the CARE checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lauren C. Hayashi, MS, Researcher, Department of Pediatrics, University of Florida College of Medicine, No. 1104 Newell Drive, Gainesville, FL 32608, United States. lauren.hayashi@ufl.edu
Received: June 6, 2023 Peer-review started: June 6, 2023 First decision: August 30, 2023 Revised: September 9, 2023 Accepted: September 26, 2023 Article in press: September 26, 2023 Published online: December 9, 2023 Processing time: 178 Days and 11.9 Hours
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.
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.
