Situs Inversus Totalis in Conjunction with an Anomalous Artery Connecting the Common Hepatic Artery and a Jejunal Branch of the Superior Mesenteric Artery: A Cadaveric Case Report.

Abstract

We encountered a case of situs inversus totalis in conjunction with an anomalous artery connecting the common hepatic artery and a jejunal branch of the superior mesenteric artery during anatomical dissection of a cadaver. The heart was located in the center of the thorax, with the apex located anterioinferiorly to the right of the midline and the base located posterosuperiorly to the left of the midline. The aortic arch coursed from right anterior to right posterior. The right lung was divided into two lobes, and the left lung was divided into three. The entire intraperitoneal gastrointestinal tract, from the stomach to the rectum, formed a mirror image with the expected normal anatomy. The liver was located on the left side of the upper abdominal cavity, and the spleen was located on the right. The cardia of the stomach was located on the right side, and the pylorus was on the left. The cecum and appendix were located on the left, and the sigmoid colon ran toward the pelvic cavity from the right. In addition to situs inversus totalis, an anomalous artery called the arc of Bühler that branched off the common hepatic artery and entered the mesenteric arcade between the first and second jejunal arteries was observed. These anomalies were not embryologically related and occurred separately from each other. However, their presence may cause confusion during abdominal surgery. Knowledge of this specific combination of anatomical variations may help surgeons who encounter it in clinical practice.