Isolated dextrogastria: a case report

Isolated dextrogastria is a rare congenital anomaly in which the stomach is right-sided while the intestines, the organs in the chest, and the other organs in the abdomen are in normal situs. The importance of recognising the spectrum of situs anomalies is because the altered anatomy associated with these anomalies may result in misdiagnosis.

To report a case of isolated dextrogastria in an 18-year old woman who was seen during pre-university admission medical examination.

The routine chest X-ray of a young woman as a part of pre-admission medical examination showed the gastric air bubble under the right diaphragm rather than on the left. She was then subjected to further clinical and radiological evaluation.

The personal, past and family histories were uneventful as was the physical examination. Trans-abdominal ultrasonography showed a normal-sized and a normally sited liver in the right hypochondrium with normal gall bladder, and normally sited left and right lobes of the liver. The liver echo pattern was normal. The stomach was found below the lower border of the right lobe of the liver. The kidneys and the spleen were normal in number, position, size and architectural pattern. A barium meal showed a well-defined and a well developed stomach with a reverse J shape and duodenal C loop that was reversed in shape.

The practice of the radiographer is always placing the marker before exposing the film instead of marking the radiograph after processing, which is the key to accurate identification of situs anomalies need emphasis.