Situs inversus totalis discovered incidentally at the age of 84 years.

To cite: Lakshman VB, Revannasiddaiah S, Ganganna R. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2013008611 DESCRIPTION Situs inversus totalis is a rare occurrence wherein the organs of an individual are ‘mirrored’ in position, with the right-sided organs swapping positions with the left. The thorax features the heart placed in the right hemithorax, with the left lung being trilobed and the right lung bilobed (figure 1). The liver lies in the left, while the spleen lies in the right (figure 2). Patients with situs inversus totalis have a 3–5% risk of congenital cardiac disease, most often the transposition of great vessels. About 20% of patients also suffer from the Kartagener syndrome, which features bronchiectasis and sinusitis as consequences of congenital ciliary dysfunction. 2 However, most patients with situs inversus totalis lead normal healthy lives, and the detection of the condition is often incidental. As an example, this case describes a lady diagnosed to have situs inversus totalis at the age of 84 years, incidentally, when she was imaged as part of the evaluation for a carcinoma of the urinary bladder. Despite the individuals leading normal routine lives, a few implications of this anatomical anomaly do exist. For example, classical clinical signs of various diseases may have to be expected on the contralateral side. Surgical interventions for any requirement must be planned keeping the patient’s anatomical uniqueness in due consideration.