Do You Know What Lurks Beneath Your Own Skin

By Emily Kaloudis

Figure 1: Diagram of Situs Inversus mirroring (Curiosity 2016)

It is impossible to know what is going on inside your body at any given time. This can be a scary prospect for many people, especially within the walls of a hospital. Not knowing why you are sick is often more daunting than being ill in the first place. Our minds go to the darkest places, usually cancer or a tumor, even if the issue is as simple as a migraine. The invention of scanning machines such as X-rays, CT scans, and MRIs have given doctors the ability to visualize internal organs without surgery. The invention of these imaging machines have truly revolutionized the medical industry, giving doctors eyes and ears within the body and enabling them to carefully plan a surgery before the patient is even asleep. Without these machines a surgeon would be completely unprepared for what they will see until they begin the surgery, and by then it may be too late. Often times this is not a problem because doctors are prepared for unexpected situations, but sometimes there are surprises waiting just beneath the patient’s skin. Sometimes, for example, the surgeon may see a lung where the heart should be, or liver where they expected to see stomach. These are very rare occurrences, but for about one in 10,000 people, this is their reality (Yilmaz 2019).

These people are living with a condition called Situs Inversus Totalis, a rare autosomal recessive mutation, which is a mutation that can only be inherited if both parents are carriers. Situs Inversus results in a person’s heart and other abdominal organs forming in incorrect positions (Yilmaz 2019). The organs appear completely mirrored across the body’s central axis compared to their typical positions (Figure 1). The condition is curiously asymptomatic, and therefore it often goes unnoticed until a person seeks medical attention for something else (Tsoucalas 2019).

In a case study following an 87 year old Turkish man who turned out to have Situs Inversus Totalis, we can see just how unpredictable the condition can be (Yilmaz 2019). The gentleman was admitted to Erciyes University’s hospital with a complaint of bloody urine. The doctors followed the usual procedure and eventually took the patient to get a CT scan. This led to two startling revelations; the patient had an unusual growth in his bladder, a tumor-- as well as Situs Inversus. This groundbreaking diagnosis of not only a tumor, but also Situs Inversus, changed this man's life forever. His tumor was resolved with a carefully planned surgery, taking into account his mirrored anatomy. Without the prior knowledge of his condition, the surgeons would never have been able to pull off the surgery that saved this man’s life. It is therefore of critical importance that doctors and paramedics are aware of this condition.

Although abnormalities like Situs Inversus are rare, they do occur. When they do, it is vital that medical practitioners know how to handle the situation. Developments of new technologies are constantly improving and increasing the amount of information a doctor can know prior to beginning a surgery. Discoveries in the medical industry truly save lives on a daily basis and help to make abnormalities such as Situs Inversus a little less spooky.

References:

Curiosity. (2016, May 27). People with Situs Inversus Have Flipped Organs. Accessed October 17, 2019. https://curiosity.com/.

Tsoucalas, G., Thomaidis, V., & Fiska, A. (2019). Situs inversus Totalis: Always recall the uncommon. Clinical Case Reports. doi: 10.1002/ccr3.2433

Yilmaz, S., Demirtas, A., Tokpinar, A., & Acer, N. (2019, September). Dextrocardia and Situs Inversus Totalis in a Turkish Subject: A Case Report. International Journal of Morphology, 37(3), 900+. Retrieved from https://link.gale.com/apps/doc/A593803347/AONE?u=vol_b92b&sid=AONE&xid=b7df0f25