Roongruangchai Jantima, Narongsak Wanida, Plakornkul Vasana, Viravud Yadaridee, Sripaoraya Kesorn, Roongruangchai Kosol
Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2012 Jan;95(1):132-8.
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.
完全性内脏反位是指胸腹部主要器官位置的完全反转。本研究报告了在一次大体解剖学医学课程的解剖过程中发现的一名87岁女性尸体支气管上皮的反转结构和组织学情况。打开胸廓，心脏尖部投影至右侧（右位心），左右肺位置互换。腹腔内器官也完全互换，肝脏位于左侧，脾脏位于右侧，腹腔肠道情况相同。上、下腔静脉位于左侧，将血液引流至左心房。奇静脉在右侧。支气管上皮的组织学及纤毛超微结构的透射电镜检查均正常。心脏移位似乎与心管旋转不良有关，导致右位心，并引起胸腹部器官位置的反转。完全性内脏反位的发病率约为1:10000，可能与原发性纤毛运动障碍（PCD）有关，PCD是指纤毛功能障碍。PCD也被称为卡塔格内综合征（KS），其特征为内脏反位、支气管扩张、慢性鼻窦炎和不孕，KS占完全性内脏反位的20-25%。然而在本研究中，纤毛的组织学和超微结构看起来正常。
