An incidental situs Inversus Totalis in a Pediatric case of granulomatous Panuveitis. A case report

Situs inversus totalis (SIT) is a rare congenital abnormality characterized by a mirror-image transposition of thoracic and abdominal organs. Although SIT is a recognized congenital anomaly, it is often unfamiliar to physicians because it is typically asymptomatic and discovered incidentally. We report the case of a 7-year-old girl from Central Honduras who presented with decreased visual acuity in the right eye, and was diagnosed with granulomatous panuveitis. Clinical evaluation revealed a right-sided apex beat, systolic murmur, and left-sided hepatic dullness. Electrocardiogram showed right axis deviation, inverted P waves in I and aVL, and positive P waves in aVR. Radiographic and Ultrasonography imaging confirmed dextrocardia, right-sided aortic knuckle, and mirror-image transposition of abdominal organs, consistent with SIT. This rare coexistence of SIT with ocular inflammation highlights the importance of multidisciplinary evaluation in atypical clinical presentations. Although often asymptomatic, SIT requires recognition to avoid diagnostic errors and guide appropriate management.