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Pak J Nucl Med. 2014; 4(1): 93-96

Scintigraphic detection of situs inversus totalis in a patient with suspected paediatric biliary atresia: a case report

Muhammad Inamullah, Mujahid Khalid Ali, Tariq Mahmood Mirza.

Congenital anomalies in infancy pose diagnostic and therapeutic difficulties. Biliary atresia is a common diagnosis in children with unrelenting neonatal jaundice with conjugated hyperbilirubinaemia. The morbidity associated with this condition is compounded by the concomitant presence of complete or partial situs inversus which is a condition in which major visceral organs are reversed from their original positions. Combination of biliary atresia with situs inversus is a challenging diagnosis to make. Equivocal ultrasonographic findings not leading to a definitive diagnosis of situs inversus, not only compound the clinical features but also lead to a delay in the correct diagnosis. Scintigraphic imaging modalities especially technetium-99m hydroxy imino diacetic acid (99mTc-HIDA) scan can play a vital role in overcoming these problems. We report a case of 2-month-old child who presented with persistent neonatal jaundice, biliary atresia, situs inversus totalis and generalized sepsis finally leading to his death.

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