Surgical and Radiologic Anatomy

, Volume 40, Issue 10, pp 1169–1172 | Cite as

Variations in vascular anatomy and unilateral adrenal agenesis in a female cadaver with situs inversus totalis

  • Ana González-Castillo
  • Santiago Rojas
  • Marisa Ortega
  • Alfonso Rodríguez-Baeza
Anatomic Variations



Situs inversus totalis is mirror transposition of thoracic and abdominal organs. Very few reports have been published on anatomic dissections of cadavers with this condition.


This work describes a case of situs inversus totalis identified during the anatomical dissection of a 91-year-old woman.


Thoracic and abdominal viscera were inverted, but otherwise normal. The aorta originated from the right ventricle, which exhibited characteristics of the systemic ventricle. The pulmonary artery originated from the left ventricle, which had a tricuspid valve, three papillary muscles, thick trabeculae, a supraventricular crest, and septomarginal trabecula. The atrial situs was concordant with ventricular morphology. Lungs and paranasal sinuses were not suggestive of Kartagener’s syndrome. Only the right adrenal gland was present, and variations in vascular anatomy were observed. The latter included: the celiac trunk branching into a phrenic artery, the splenic artery and a right gastric artery; the common hepatic artery originating from the superior mesenteric artery; and, on the left side, two inferior thyroid arteries, both originating from thyrocervical trunk. The occurrence of a double inferior thyroid artery and agenesis of adrenal gland was never communicated in situs inversus. Embryonic origin of celiac trunk and superior mesenteric artery variations could be explained by the separation at higher levels of the longitudinal anastomoses formed between the four roots of omphalomesenteric artery.


It can be hypothesized that this phenomenon could occur more frequently in situs inversus than in situs solitus. However, the number of cases investigated in such detail is too small to draw firm conclusions.


Situs inversus totalis Superior mesenteric artery Celiac trunk Inferior thyroid artery Adrenal agenesis 


Author’s contribution

AG-C: Data collection, Data analysis. SR: Data analysis, Manuscript writing/editing. MO: Data collection. AR-B: Protocol/project development, Data analysis, Manuscript writing/editing.

Compliance with ethical standards

Conflict of interest

Authors declare no conflict of interest.


  1. 1.
    Afzelius BA (1976) A human syndrome caused by immotile cilia. Science 193:317–319CrossRefPubMedGoogle Scholar
  2. 2.
    Brassett C, Ellis H (1991) Transposition of the viscera a review. Clin Anat 4:139–147CrossRefGoogle Scholar
  3. 3.
    Casey B (1998) Two rights make a wrong: human left-right malformations. Hum Mol Genet 7:1565–1571CrossRefPubMedGoogle Scholar
  4. 4.
    Chandraraj S (1976) Observations on some additional abnormalities in situs inversus viscerum. J Anat 122:377–388PubMedPubMedCentralGoogle Scholar
  5. 5.
    Cigali BS, Ulucam E, Bozer C (2008) Accessory inferior thyroid artery and internal thoracic artery originating from the thyrocervical trunk. Anat Sci Int 83:283–285CrossRefPubMedGoogle Scholar
  6. 6.
    Douard R, Feldman A, Bargy F, Loric S, Delmas V (2000) Anomalies of lateralization in man: a case of total situs inversus. Surg Radiol Anat 22:293–297CrossRefPubMedGoogle Scholar
  7. 7.
    Hiatt JR, Gabbay J, Busuttil RW (1994) Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg 220:50–52CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Mano Y, Adachi N, Murakami G, Yokoyama T, Dodo Y (2006) Human situs inversus of the thoracoabdominal structures. Anat Sci Int 81:7–20. CrossRefPubMedGoogle Scholar
  9. 9.
    Michels NA (1966) Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg 112:337–347CrossRefPubMedGoogle Scholar
  10. 10.
    Provost JM, Hoffman CM, Ryan JF, Vines DH (1971) Hypoplastic inferior vena cava with aplasia of the right kidney and absence of the right adrenal gland. Ann Surg 174:843–848CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Ryo UY (1981) Unilateral visualization of the adrenal gland. Semin Nucl Med 11:224–225CrossRefPubMedGoogle Scholar
  12. 12.
    Schlösser TPC, Semple T, Carr SB, Padley S, Loebinger MR, Hogg C, Castelein RM (2017) Scoliosis convexity and organ anatomy are related. Eur Spine J 26:1595–1599. CrossRefPubMedGoogle Scholar
  13. 13.
    Tandler J (1904) Über die varietäten der arteria coeliaca und deren entwickelung. Ant Hefte 25:472–500Google Scholar
  14. 14.
    Tubbs RS, Wellons JC 3rd, Oakes WJ (2005) Split cord malformation and situs inversus totalis: case report and review of the literature. Childs Nerv Syst 21:161–164. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Ana González-Castillo
    • 1
    • 2
  • Santiago Rojas
    • 1
  • Marisa Ortega
    • 1
    • 3
  • Alfonso Rodríguez-Baeza
    • 1
  1. 1.Unit of Human Anatomy and Embryology, Department of Morphological Sciences, Faculty of MedicineUniversitat Autònoma de BarcelonaBarcelonaSpain
  2. 2.Service of General and Digestive Surgery, Hospital Universitari del MarUniversitat Autònoma de BarcelonaBarcelonaSpain
  3. 3.Institute of Legal Medicine and Forensic Sciences of CataloniaHospitalet de LlobregatBarcelonaSpain

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