Abstract :
The term "Situs inversus" is a diminutive for "Situs inversus viscerum" which means in Latin: inverted position of the internal organs. It was first described in 1643 and has an incidence of approximately 1 /10,000 births. A mirror image of the original anatomical configuration represents the situs inversus totalis.
Several authors described anomalies in the rotation and fixation of viscera during their development. These developmental anomalies are not necessarily the cause of functional problems. The clinical and surgical implications can be significant, as several authors reported a situs inversus totalis over the most conventional surgical procedures. The technical difficulties represent the main challenge. Because even though many patients are known to have situs inversus totalis, surgeons need an adaptation time to get used to the mirror image of viscera. Iatrogenic injuries and an increase in operative time are not uncommon.
We report a case of situs inversus totalis in a 68-years-old patient, accidentally discovered during investigations for an adenocarcinoma of the prostate. We remind in detail the anatomical presentation and morphological aspects found in our patient. Several hypotheses have been mentioned to explain the pathogenesis of situs inversus. Even if the anatomical inversion of many organs has been genetically studied, it appears a predominance for the viscera whose positional abnormalities are the most obvious (heart, liver, stomach). For other naturally "symmetrical" organs the inverted position is much less obvious,
if not controversial, as is the case with the brain. The term "situs inversus totalis" is used to describe the transposition of all organs of the body to the opposite side, its incidence is relatively low. Situs inversus totalis is a rare pathological condition, but
with important clinical and surgical implications. Even if its discovery is most often fortuitous, hospital practitioners (especially surgeons and radiologists) must take this possibility into account, especially for patients awaiting surgery.
Keyword :
Situs inversus totalis, Developmental anomaly, Organ transposition, Fortuitous discovery.