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Sitio inversus totalis con empema pleural: una pista para la disfunción ciliar

Suraj Pai¹, Anusha Induraj², Aparna Mohan K¹

¹Cardiovascular and Thoracic Surgery, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangaluru, Karnataka, India.

BMJ case reports

|August 21, 2025

Resumen

El sitio inverso total (SIT) puede indicar discinesia ciliar primaria (PCD), una afección que causa infecciones pulmonares recurrentes. El reconocimiento temprano de la SIT ayuda en el diagnóstico de la PCD y la prevención de complicaciones pulmonares graves como el empema.

Área de la Ciencia:

La genética médica
Pulmonología
Anomalías congénitas

Sus antecedentes:

El sitio inversus totalis (SIT) es una rara condición congénita con reversión completa de órganos.
La SIT se asocia frecuentemente con discinesia ciliar primaria (PCD), un trastorno del aclaramiento mucociliar.
El diagnóstico tardío de PCD puede conducir a un daño pulmonar severo y progresivo.

Objetivo del estudio:

Para resaltar la asociación entre SIT y PCD.
Hacer hincapié en la importancia de reconocer la SIT como una pista de diagnóstico temprano para la PCD.
Para subrayar la necesidad de una intervención oportuna en pacientes con sospecha de disfunción ciliar.

Principales métodos:

Informe de caso de un varón adolescente con SIT que se presenta con empíema pleural del lado izquierdo.
Evaluación clínica que incluya imágenes y análisis del líquido pleural.
Intervención quirúrgica: toracotomía con decorticación para el pulmón atrapado y el empema.

Principales resultados:

El paciente presentaba síntomas que sugerían una disfunción ciliar subyacente.
El tratamiento conservador no tuvo éxito, requiriendo intervención quirúrgica.
La toracotomía con decorticación expandió con éxito el pulmón y trató el empema.

Conclusiones:

El sitio inversus totalis sirve como un marcador fenotípico crucial para la discinesia ciliar primaria.
La identificación temprana de la SIT puede facilitar el diagnóstico y el tratamiento rápidos de la PCD.
La intervención proactiva es esencial para mitigar la morbilidad pulmonar a largo plazo en pacientes con PCD.

Palabras clave:

Variaciones anatómicas Cirugía cardiotorácica Empiema en el cuerpo

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