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      Situs inversus en paciente con enfermedad Trofoblastica gestacional Translated title: Situs inversus in patients with disease gestational trophoblastic. Translated title: Situs inversus em paciente com doença trofoblástica gestacional


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          Resumen Introducción. Situs inversus es un padecimiento poco frecuente en nuestro medio, siendo una alteración congénita del desarrollo embrionario, que se caracteriza por la inversión en espejo de todos los órganos pares. Caso clínico. Paciente de 44 años de edad, internada por el servicio de consulta externa en la Maternidad Germán Urquidi por enfermedad trofoblástica gestacional, anemia moderada. Durante su internación se solicitan estudios complementarios, los cuales en su mayoría reportan como hallazgo esta patología, con inversión de órganos internos del lado contrario. Fue intervenida quirúrgicamente con histerectomía total más salpingooforectomia bilateral, el diagnóstico fue oportuno, para evitar error en los procedimientos posteriores. Conclusión. El diagnóstico temprano es fundamental, dado que el abordaje quirúrgico torácico y abdominal es diferente y determinadas patologías pueden presentarse con clínica inusual. Además, también se puede estudiar la presencia de alteraciones asociadas entre ellas la discinesia ciliar primaria (Síndrome de Kartagener).

          Translated abstract

          Abstract Introduction. Situs inversus is a rare condition in our midst, being a congenital alteration of embryonic development, that is characterized for mirror inversion of all even organs. Clinical case. 44 years old patient who is hospitalized by the outpatient service in the hospital “Maternidad German Urquidi” for disease gestational trophoblastic, moderate anemia. During his hospitalization, complementary studies are requested which mostly of them report this pathology as a finding, with inversion of internal organs of the opposite side. This patient underwent surgery with total hysterectomy and bilateral salpingoophorectomy, his diagnosis was timely to avoid error in subsequent procedures. Conclusion. Early diagnosis is essential since the thoracic and abdominal surgical approach is different. Certain pathologies may occur with unusual clinic. Also it can be studied the presence of associated alteration between them the primary ciliary dyskinesia. (Katagener syndrome).

          Translated abstract

          Resumo Introdução: Situs Inversus é uma patologia pouco frequente em nosso meio, sendo uma alteração congênita do desenvolvimento embrionário, que se caracteriza pela inversão de espelho de todos os órgãos pares. Caso clínico: Paciente de 44 anos de idade, internada pelo serviço de consulta externa na Maternidade Germán Urquidi por apresentar enfermidade trofoblástica gestacional, anemia moderada. Durante sua internação, são solicitados estudos complementares, nos quais, em sua maioria, apontam como achado, a referida patologia, com inversão de órgãos internos do lado oposto. Foi realizada intervenção cirúrgica, com histerectomia total mais salpingo-ooforectomia bilateral, com diagnóstico oportuno, para evitar erros nos procedimentos subsequentes. Conclusão: O diagnóstico precoce é fundamental, uma vez que a abordagem cirúrgica torácica e abdominal é diferente. Determinadas patologias podem apresentar sintomas incomuns. Além disso, pode-se estudar a presença de alterações associadas, incluindo discinesia ciliar primária (síndrome de Kartagener).

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          Most cited references11

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          Clinical aspects of defects in the determination of laterality.

          Of individuals in the human population, 99.99% have developed identical thoracoabdominal asymmetry with the cardiac apex, a bilobed lung, the stomach, and the spleen on the left side of the midline, and the vena cavae, a trilobed lung, the appendix, and the larger liver lobe on the right. This arrangement of organs is situs solitus. Occasionally, individuals have a complete, mirror-image reversal of this asymmetry called situs inversus, and 20-25% of those individuals have an autosomal recessive condition, Kartagener syndrome, with ciliary dyskinesia, bronchiectasis, sinusitis, and infertility. Between these extremes of situs solitus and situs inversus lies the spectrum of situs ambiguus, characterized by isomerism, heterotaxy, and multiple malformations in one or more thoracic or abdominal organs. Although most abnormal situs in humans occurs sporadically, growing evidence suggests that interference with normal genetic mechanisms and pathways may be responsible for most cases. Familial cases suggest major effects of both autosomal and X-linked genes with both dominant and recessive expression. Situs inversus and situs ambiguus (SI/SA) occurring in probands who have close relatives with "isolated," nonsyndromic birth defects suggests that some of the pathways important in situs determination may also be involved in causing sporadic malformations not obviously associated with a defect in laterality determination. Human phenotypes of interest include the association of SI/SA with short rib-polydactyly syndromes and renal-hepatic-pancreatic dysplasia, and with agnathia and holoprosencephaly. Further elucidation of the developmental pathways involved in left-right axis determination should shed light on the causes of and relationships among these human phenotypes. Copyright 2001 Wiley-Liss, Inc.
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            Situs inversus totalis.

            J M Spoon (2001)
            The etiology of situs inversus totalis remains uncertain. However, the literature establishes that isolated situs inversus totalis is usually asymptomatic in the neonate. This case study illustrates the importance of physical assessment skills in identifying situs inversus totalis in the neonate. Current research may reveal the etiology of this rare but fascinating abnormality.
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              Genetics of human left-right axis malformations.

              Like all vertebrates, humans establish anatomic left-right asymmetry during embryogenesis. Variation from this normal arrangement (situs solitus) results in heterotaxy, expressed either as randomization (situs ambiguus) or complete reversal (situs inversus) of normal organ position. Familial heterotaxy occurs with autosomal dominant, recessive, and X-linked inheritance. All possible situs variants--solitus, ambiguus, inversus--can appear among some heterotaxy families. Positional cloning has led to the identification of a gene on the X chromosome responsible for some cases of human heterotaxy. In addition to their medical relevance, human studies provide a unique contribution to our understanding of left-right axis development among all vertebrates.

                Author and article information

                Revista Científica de Salud UNITEPC
                Revista UNITEPC
                Universidad Tecnica Privada Cosmos (Cochabamba, , Bolivia )
                June 2021
                : 8
                : 1
                : 57-63
                [1] Cochabamba orgnameHospital Materno Infantil German Urquidi. Bolivia jaque80273@ 123456hotmail.com
                [2] Cochabamba orgnameHospital Materno Infantil German Urquidi Bolivia scepedessandoval@ 123456hotmail.com
                S2520-98252021000100057 S2520-9825(21)00800100057

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                : 20 May 2021
                : 03 March 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 11, Pages: 7

                SciELO Bolivia

                CASOS CLÍNICOS

                Dextrocardia,Enfermedad Trofoblástica Gestacional,Diagnóstico (Fuente: Descriptores en Ciencias de la Salud DeCS),Situs Inversus,Gestational Trophoblastic Disease,Diagnosis. (source: Health Sciences Descriptors DeCS).,Doença Trofoblástica Gestacional,Diagnóstico. (fonte: Descritores em Ciências da Saúde: DeCS).


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