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AlHamdan, Khankan, AlFattani, and AlOtaibi: The prevalence of visceral transposition in a Saudi national institute – a preliminary study

Introduction: Few studies have addressed the prevalence and incidence of visceral transposition, but one that has is a Sri Lankan study, which found that the incidence of visceral transposition in chest clinics is 1 in 3567.

Objectives: To investigate the prevalence of visceral transposition (situs inversus, dextrocardia and heterotaxy) in the National Guard Health Affairs (NGHA) hospital, and its association with heart disease, Kartagener syndrome and primary ciliary dyskinesia (PCD).

Materials and methods: A computerized system was used to search a total of 25 168 patients (age: from birth to 14 years), who underwent thoracoabdominal radiographs in 2013, for these keywords: dextrocardia, mesocardia, asplenia, polysplenia, isomerism, situs inversus and situs ambiguous. The computerized search matched the keywords with 132 patients, which were then reviewed for inclusion in the study and exclusion criteria using the picture achieving and communication system.

Results: The overall prevalence of visceral transposition in NGHA is 1 in 500. Among the sample size (n = 56) (31 males and 25 females), 22 had situs inversus, 14 had situs ambiguous (8 of them had left isomerism and 6 of them had right isomerism) and 20 had situs solitus with single organ disposition (heart). In addition, 48 patients had dextrocardia and only 1 had mesocardia. Gender distribution was about equal between males and females, except in right isomerism; 83.3% and 16.7% for males and females, respectively. Heart disease was found in 41 patients among the sample size (n = 56), 26 males and 15 females, with a significant P-value (0.0449). Only two patients had Kartagener syndrome, and both were female (P = 0.1948), and only one female had PCD (P = 0.4464).

Conclusions: The prevalence of visceral transposition was high compared with other published studies. Heart disease association was significantly higher in males than in females, which prompts further research for genetic linkages and investigations.

Acknowledgements: Hala Bin Zaid for help with reviewing data.

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