Dextrocardia and asplenia in situs inversus totalis in a baby: a case report

INTRODUCTION: Situs inversus with dextrocardia is the complete inversion of position of the thoracic and abdominal viscera. It may be isolated or associated with malformations, especially cardiac and/or alimentary. It may be discovered in infancy because of associated anomalies but often remains asymptomatic and discovered incidentally in adult life. Only a small number of cases have been reported from India. CASE PRESENTATION: We report the case of a 7-month-old Indo-Aryan baby girl found to have dextrocardia with situs inversus totalis who presented with fever, cough and respiratory distress. A chest X-ray showed her heart in the right hemithorax with the cardiac apex pointing towards the right. The findings of an electrocardiogram and echocardiography confirmed the location of her heart in the right hemithorax and an abdominal sonogram showed her liver and gall bladder in midline of her abdomen whereas her stomach was located more towards the right side, her spleen was absent. CONCLUSIONS: Situs inversus totalis, although a rare condition, should be sought for when clinical and radiologic findings indicate dextrocardia, especially as it may be an incidental finding. Doctors should encourage routine medical examination for their patients which could help identify this anomaly, thereby preventing wrong diagnosis and possibly death due to delay in management.