ArticleAbdominal radiology (New York)2026
CT assessment of colonic laterality in situs inversus and situs ambiguus: a multicenter retrospective study.
Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo characterize proximal and distal colonic laterality and appendiceal-base location on CT in patients with situs inversus and situs ambiguus.
methodsThis retrospective multicenter study included 79 patients identified from abdominal CT reports at three tertiary hospitals between December 2003 and March 2025 (70 with situs inversus; 9 with situs ambiguus). A radiologist assessed thoracoabdominal organ arrangement, proximal and distal colonic laterality, combined proximal-distal colonic laterality pattern, and appendiceal-base location. The end of the cecum was used when the appendiceal base was not visible. Distributions of colonic laterality between the two situs types were compared using exact tests.
resultsIn situs inversus, the proximal colon was left-sided in 66/70 patients (94.3%; 95% CI, 86.2-97.8), the distal colon was right-sided in 67/70 (95.7%; 95% CI, 88.1-98.5), and a left-proximal/right-distal combined colonic pattern occurred in 64/70 (91.4%; 95% CI, 82.5-96.0). The appendiceal base or cecal surrogate was in the left lower quadrant in 61/70 (87.1%; 95% CI, 77.3-93.1). In situs ambiguus, the proximal colon was midline-crossing in 7/9 patients (77.8%; 95% CI, 45.3-93.7), and the distal colon was left-sided in 6/9 (66.7%; 95% CI, 35.4-87.9). Locations of the appendiceal base or cecal surrogate were distributed across all abdominal regions. Distributions of segmental and combined colonic laterality differed between situs inversus and situs ambiguus (all exact p < .001).
conclusionSitus inversus usually shows mirror-image colonic laterality and a left-lower-quadrant appendiceal base, but exceptions occur. In this cohort, situs ambiguus showed greater variability. Colonic laterality and appendiceal-base location should be directly assessed on CT rather than inferred from situs classification alone.
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