Lung resection for primary bronchial carcinoma in a patient with complete situs inversus

Complete situs inversus is a rare syndrome with a frequency estimated at 1-2/10,000 births. Situs inversus may go unrecognized until discovery during emergency surgery or investigation of symptoms. We present a case of confirmed adenocarcinoma of the left lung, treated by upper lobectomy. The computed tomography (CT) scan of the thorax showed a mirror-image of the organs and vessels, confirmed by aortography and pneumoangiography. The heart was structurally normal. Abdominal CT scan showed a mirror-image of the abdominal organs. At thoracotomy, the gross appearance of the left lung and the arrangement of the pulmonary vessels and the bronchi corresponded to that normally found on the right side. Preoperative diagnosis of situs inversus in patients undergoing surgical treatment is important for operative technique and prevention of vessel injury. Preoperative angiographic examination is mandatory in patients with situs inversus undergoing lung resection.