A case of hepatectomy for total situs inversus with Kartagener syndrome

The clinical treatment of situs inversus is difficult due to the inverted mirror-imaged anatomy and accompanying anomalies. A 55-year-old woman with total situs inversus and Kartagener's syndrome (bronchoectasia, chronic sinusitis and dextrocardia) was found to have a large-sized hepatic angiogenic tumor in the posterior sector and underwent successful hepatectomy. Concomitant anomalous anatomy included interruption of the inferior vena cava at the liver and azygous continuation, hepatic veins flowing into the right atrium, polysplenia, agenesis of the dorsal pancreas, and malrotation of the intestine. In hepatic resection for situs in-versus, it is thus important to be aware of this inverted mirror imaging and to confirm organic and vascular anatomical anomalies.