An incidental situs Inversus Totalis in a Pediatric case of granulomatous Panuveitis. A case report

TL;DR

A 7-year-old girl with eye inflammation was found to have a rare condition where her internal organs were mirrored, highlighting the need for thorough evaluations in unusual cases.

Contribution

This case report highlights the rare coexistence of situs inversus totalis with granulomatous panuveitis in a pediatric patient.

Findings

The patient exhibited dextrocardia and mirrored abdominal organs consistent with situs inversus totalis.

Granulomatous panuveitis was diagnosed alongside the anatomical abnormalities.

The case underscores the importance of multidisciplinary evaluation in atypical presentations.

Abstract

Situs inversus totalis (SIT) is a rare congenital abnormality characterized by a mirror-image transposition of thoracic and abdominal organs. Although SIT is a recognized congenital anomaly, it is often unfamiliar to physicians because it is typically asymptomatic and discovered incidentally. We report the case of a 7-year-old girl from Central Honduras who presented with decreased visual acuity in the right eye, and was diagnosed with granulomatous panuveitis. Clinical evaluation revealed a right-sided apex beat, systolic murmur, and left-sided hepatic dullness. Electrocardiogram showed right axis deviation, inverted P waves in I and aVL, and positive P waves in aVR. Radiographic and Ultrasonography imaging confirmed dextrocardia, right-sided aortic knuckle, and mirror-image transposition of abdominal organs, consistent with SIT. This rare coexistence of SIT with ocular inflammation highlights the importance of multidisciplinary evaluation in atypical clinical presentations. Although often asymptomatic, SIT requires recognition to avoid diagnostic errors and guide appropriate management.

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