Patient is a 27 -year-old male with history of lung transplant who was referred for gastric emptying study, to evaluate for gastroparesis. Dynamic images of the stomach were acquired 1 minute per frame for 1 hr, in anterior and posterior projections, after the oral administration of an egg sandwich labeled with approximately 1.0 mCi of Tc-99m sulfur colloid.

The dynamic images above show a reversed contour of the stomach. The protocol displays images from the anterior camera head first, followed by the posterior camera head. Camera head positioning was confirmed and patient’s history reviewed. The ROI analysis below shows gastroparesis with only 20% emptying at the end of 1 hour.

Situs inversus is a congenital condition in which transposition of the viscera in the thorax and abdomen occurs where the major visceral organs are reversed or mirrored from their normal positions. The heart is located on the right side of the thorax, the stomach and spleen on the right side of the abdomen and the liver and gall bladder on the left side.

Approximately 25% of patients with complete situs inversus also have Primary Ciliary Dyskinesia (Kartagener Syndrome), characterized by the triad of situs inversus, chronic sinusitis, and bronchiectasis.

Representative images from patient’s CT scan confirm Situs Inversus and location of the fundus of the stomach, below the right hemi-diaphragm.