Vascular anatomy and their variations in Situs inversus totalis using postmortem computed tomographic angiography

Area of Science:

• Radiology
• Anatomy
• Forensic Pathology

Background:

• Limited studies exist on vascular system variations in Situs inversus totalis (SIT).
• Whole-body computed tomographic (CT) angiography provides a comprehensive view of vascular anatomy.

Observation:

• A case of SIT underwent postmortem CT angiography (PMCTA) during a forensic investigation.
• The PMCTA procedure utilized a multiphase protocol to visualize the entire vascular system.
• The major vessels were observed in a reversed anatomical pattern.

Findings:

• Contrast flow interruptions in right coronary arterial branches indicated possible blockage.
• Autopsy confirmed >90% occlusions in several coronary locations, leading to ischemic heart disease.
• Anomalous origins of the right internal mammary artery, an abnormal left thyrocervical trunk, and variations in testicular vein drainage were identified.

Implications:

• Findings contribute to the limited literature on vascular anatomy in SIT.
• This case may assist clinicians in understanding and managing patients with SIT.
• The study underscores the utility of PMCTA in forensic investigations and anatomical research.