Abdominal situs inversus, also called abdominal heterotaxia or isolated levocardia, is characterized by inversion of the abdominal viscera but with a normally located heart in the left hemithorax.
The consensus in the literature has been for many years that given the high incidence of malrotation and serious heart disease in heterotaxia, high risk of performing emergency Ladd's procedure in such a patient and morbidity and mortality associated to volvulus, all children with heterotaxia should be screened for intestinal rotational abnormalities using upper gastrointestinal contrast studies and that, if such an abnormality is found, a prophylactic modified Ladd's procedure should be performed (5-8).
We support the use of prophylactic Ladd's procedure in patients with heterotaxia and malrotation given the low risk associated with the procedure, high risk of volvulus, and high incidence of congenital cardiac defects in these patients.
(5.) Chang J, Brueckner M, Touloukian RJ: Intestinal rotation and fixation abnormalities in heterotaxia: early detection and management.
Heterotaxia with polysplenia, also known as left isomerism or bilateral left-sidedness, is characterized by a midline or ambiguous location of the majority of chest and abdominal viscera, multiple spleens, and an absence of some right-sided structures, such as the IVC.
Heterotaxia or situs ambiguous with polysplenia is a rare spectrum of congenital abnormalities involving the visceral organs and cardiovascular structures in the chest and abdomen.