Incidental diagnosis of situs ambiguus in adulthood during the preoperative workup for gastro-oesophageal reflux disease.

Situs ambiguus is a rare congenital laterality disorder, usually diagnosed during childhood because of its association with cardiac and visceral malformations. We report a 30-year-old woman evaluated for refractory gastro-oesophageal reflux disease. Thoracoabdominopelvic computed tomography identified situs ambiguus with features suggestive of left isomerism, interruption of the inferior vena cava with azygos continuation, a retroaortic left renal vein, a midline liver, dextrogastria, right-sided polysplenia and bilateral left-sided lung morphology. Cardiological assessment ruled out significant structural heart disease. Incidental diagnosis during adulthood is important for recognising vascular and visceral variants and for the safe planning of surgical, endoscopic and interventional procedures.