The Teaching Point

Situs ambiguous describes an abnormal position of the thoracoabdominal organs and can be categorized between two extremes; right-sided isomerism with asplenia and left sided isomerism with polysplenia. Situs ambiguous describes a wide range of possible anatomic arrangements which are associated with different likelihoods of coexistent congenital heart disease. Therefore, a detailed imaging survey should be undertaken to delineate a patient`s particular anatomy.






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From the manuscript

Situs Ambiguous, Levocardia, Right Sided Stomach, Obstructing Duodenal Web, and Intestinal Nonrotation: A Case Report

Free full text article: Situs Ambiguous, Levocardia, Right Sided Stomach, Obstructing Duodenal Web, and Intestinal Nonrotation: A Case Report

Abstract
When approaching a case with a situs abnormality, using the proper terminology, making a specific diagnosis, and understanding the other often associated abnormalities that need to be excluded are of great importance. We present a case of situs ambiguous in the presence of intestinal nonrotation and an obstructing duodenal web. Our patient initially presented at two days old with bilious emesis and failure to pass meconium after birth. An abdominal radiograph demonstrated an unusual bowel gas pattern, a reversed "double bubble" sign. A subsequent thorough imaging survey was crucial to further characterize our patient`s unique anatomy. Overall, our case demonstrates many of the unusual plain radiographic and sonographic findings associated with our patient`s situs abnormality and allows for review of situs abnormalities and their significance.






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