Radiological Findings of Situs Inversus Totalis Associated with Autosomal Dominant Polycystic Kidney Disease (ADPKD) : A Case Report

Abstract

Situs inversus totalis (SIT) is a rare congenital anomaly characterized by the complete mirror-image reversal of thoracic and abdominal organs. Although often asymptomatic and incidentally discovered through routine imaging, SIT presents significant clinical challenges, especially during emergency procedures due to its unusual anatomical presentation. This case report describes a 47-year-old male presenting with chronic vomiting, whose imaging studies revealed reversed organ positions, including a left-sided liver and gallbladder, and a right-sided cardiac apex. Further investigations also revealed bilateral renal enlargement with multiple cortical and medullary cysts consistent with Autosomal Dominant Polycystic Kidney Disease (ADPKD). Advanced radiological imaging—ultrasound, X-ray, CT, and MRI—played a pivotal role in confirming both the diagnosis of SIT and identifying the associated renal pathology. SIT may coexist with other conditions such as Kartagener syndrome, heterotaxy, or various cardiovascular, gastrointestinal, and renal malformations. The co-occurrence of SIT and ADPKD is exceedingly rare and may reflect a shared developmental abnormality involving ciliary function. This case highlights the pivotal role of radiological imaging in identifying anatomical variations, detecting associated abnormalities, and guiding appropriate clinical management. Awareness of such uncommon condition is essential to avoid missed diagnosed and procedural errors.