Correspondence

Situs Inversus?

N Engl J Med 1994; 331:205July 21, 1994

Article

To the Editor:

Dr. Spigelman's chest roentgenogram of an 11-year-old girl, entitled “Situs Inversus” (March 3 issue),1 is most likely an example of situs ambiguus and polysplenia syndrome. Although the aortic arch is right-sided, which would be concordant with situs inversus totalis, there is a prominent density to the left of the trachea. Despite the underpenetration of the reproduction with respect to the mediastinum, this appears to represent an enlarged azygos vein, indicating azygous continuation of an interrupted inferior vena cava. Such an occurrence would be essentially diagnostic of the polysplenia syndrome in this context2.

Marta Hernanz-Schulman, M.D.
Vanderbilt Medical Center, Nashville, TN 37232

2 References

1. 1

   Spigelman AD. Situs inversus. N Engl J Med 1994;330:606-606
   Full Text | Web of Science | Medline

2. 2

   Hernanz-Schulman M, Ambrosino MM, Genieser NB, et al. Current evaluation of the patient with abnormal visceroatrial situs. AJR Am J Roentgenol 1990;154:797-802
   Web of Science | Medline