Omar A Ibrahim, MD, Surgical Resident, Tahir I Yunus, General Surgery and Bariatric Consultant, Ahmed M Mai, MD, Surgical Resident. International Medical Center
Situs inversus totalis (SIT) is an rare medical condition where thoracic and abdominal organs are in the mirror-image reversal of their natural position. Many difficulties faces surgeons to diagnose and manage chronic cholecystitis via laparoscopic cholecystectomy in patient with SIT. This is because the changes in the anatomical positions of organs influences the location of signs and symptoms of the diseased organ in addition to the special demands on the diagnostic and surgical skills of the surgeons. The current case report illustrates one of these cases in term of diagnosis and management.
Case presentation: A 32 years old female came to the clinic with chronic cholecystitis and multiple gallstones, in addition to dextrocardia on chest radiograph. The CT scan demonstrated SIT, cholecystitis and cholelithiasis. Laparoscopic cholecystectomy was conducted using mirror image port placement of conventional laparoscopic cholecystectomy. A right-handed surgeon conducted the operation, with reoriented visual images and the surgical steps were performed in clock wise rotation manner.
Conclusion: Chronic cholecystitis in SIT patient is considered to be a rare condition. Several precautions should be taken for proper diagnosis and adequate laparoscopic cholecystectomy procedures. Mirror image techniques, using right-handed surgeon, reoriented visual images and performing in a clock wise rotation were essential steps for the surgery success.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91641
Program Number: P208
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster