Illustrated Encyclopedia of Human Anatomic Variation: Opus IV: Organ Systems: Digestive System and Spleen

Stomach

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed

In complete transposition of the viscera, the stomach will lie on the right side.

Congenital hourglass constriction of the stomach is rare (46 of 50 cases reported, however, were in women).

Congenital stenosis of the pylorus occasionally occurs.

There may also be a doubled or tripled pyloric antrum, or the antrum may be replaced by a tube with thickened walls.

The fundus of the stomach sometimes has a diverticulum.

The stomach may be partially retroperitoneal (along with the spleen and left lobe of the liver). This is usually associated with defective mesenteries and omenta.

Heterotopic islands of pancreatic tissue have been found in the stomach wall.

Situs inversus has an incidence of 1:4000 in Japan, 1:5000 in Israel, and 1:10,000-15,000 in the United States and Northern Europe. Situs Inversus was recognized by Fabricus in 1600 when he described a case of reversed liver and spleen. Petrius Servius in 1615 described total transposition of viscera. Another similar observation was made by Riolan in 1668 in a case of an executed criminal and in the Queen of France, Marie de Medici (1573-1642), was still another authenticated case (Beck). Kuchenmeister in 1824 recognized situs inversus in a living person for the first time. LeWald demonstrated the difficulty in obtaining valid statistics for situs inversus. LeWald reports that on physical examination the reported frequency is 1/35,000, from the dissecting room 1/10,000, from post-mortem examination 1/5,000, and from roentgen examination 1/1,400.

In a study of 18,480 operated patients, 25 children and four adults had variations of position of abdominal viscera. In 15 cases there was one complete absence of intestinal rotation, three cases of incomplete rotation, nine cases of abnormal rotation, and two cases of situs inversus. Situs inversus has been associated developmentally with nonmotile cilia (Afzelius, 1976) and is transmitted as an autosomal recessive trait (Kartagner's syndrome). Immotile cilia resulting in sterility and chronic bronchitis may accompany situs inversus.

Situs Inversus (Transposition of Viscera)

References

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Hofmann, A.H. (1926) Familiärer situs inversus. Zentralbl. f. Chir. 53:1633-1634.

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Kartagener, M. (1933) Zur Pathogenese der Bronchiektasien. I Mitteilung: Bronchiektasien bei Situs viscerum inversus. Beitr. z. Klin. der Tubertk. 93:489-501.

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Legroux, -. (1856) Cancer du pylore, - Diagnostic rendu douteux par une transposition générale des vicères. Gaz. Hôp. 29:466.

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