Situs Inversus Totalis and Ultrastructure of Respiratory
Cilia: Report of a Cadaveric Case
Jantima Roongruangchai DDS, PhD*, Wanida Narongsak MS*,
Vasana Plakornkul MS*, Yadaridee Viravud DDS MS*,
Kesorn Sripaoraya MS*, Kosol Roongruangchai MD**
Affiliation :
* Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
** Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Situs inversus totalis is the complete reversal of positions of major thoracic and abdominal organs. The present
study reports the reversed structures and histology of the epithelium of bronchus of a female cadaver, 87 years of age, which
was found during the dissection in a medical course of gross anatomy. Opening the thoracic cage, the apex of heart was
projected to the right side (dextrocardia) while the right and left lungs were alternated. Intra-abdominal organs were also
completely alternated, as the liver situated on the left while spleen on the right and the same as the abdominal intestinal tract.
The superior and inferior vena cavae located on the left side and drained blood into the left atrium. The azygos vein was on
the right. The histology of the epithelium of bronchus and the transmission electron microscopy of the cilium ultrastructure
were normal. Cardiac displacement seems to be associated with malrotation of the heart tube leads to dextrocardia and
causes the inversion of positions of the thoracic and abdominal organs. The incidence of situs inversus totalis is approximately
1: 10,000 and may be associated with primary ciliary dyskinesia (PCD) which refers to the dysfunction of cilia. PCD is also
known as Kartagener syndrome (KS) which is characterized by situs inversus, bronchiectasis, chronic sinusitis and infertility,
KS represents 20-25% of situs inversus totalis. However, in the present study, the histology and ultrastructure of cilia appear
normal.
Keywords : Situs inversus totalis, Dextrocardia, Cilia, Primary ciliary dyskinesia (PCD)
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