Surat, India.

Case report

We report a case of a right isomerism associated with heart defect and asplenia. Healthy G1P0 with non-contributive personal or family history was referred to our department for the ultrasound scan at 23 weeks. Ultrasound examination revealed the following findings.

• Situs ambiguus; stomach on the left side, heart on the right side, gallbladder on the left
• Heart anomaly; common atrium, atrioventricular septal defect with a single A-V valve
• Aorta and inferior vena cava both on the left.

Patient decided to continue in her pregnancy.

Images 1,2: Image 1 shows a heart and stomach being on the opposite side. Image 2 shows a four chamber view with a visible ventricular septal defect and common atrium with common A-V valve.

Images 3,4: Image 3 shows stomach on the left, heart on the right. Image 4 shows an apparent heart defect, common atrium and ventricular septal defect. 

Images 5,6: Images show a four chamber view with apparent ventricular septal defect and common atrium.

Images 7,8: Image 7 shows a color Doppler demonstrating the single inflow due to the common atrium and A-V septal defect. Image 8 shows a regurgitation during the systoly.

Images 9,10: Image 9 shows the stomach and gallbladder on the left. Image 10 shows an aorta and inferior vena cava running along each other on the same side of the spine.

Images 11,12: Image 11 shows aorta running along the spine; inferior vena cava returning to the left-sided right atrium. Image 12 shows a ventricular septal defect and common atrium.

Images 13,14: Image 13 shows inferior vena cava returning to the right atrium. Image 14 shows the aortic arch.

Video: Video shows the heart defect, common atrium with ventricular septal defect; aorta and inferior vena cava running on the left side along the spine, stomach located on the left and heart located on the right.