Situs inversus totalis, renal and pancreatic dysplasia, and cysts as an autosomal recessive new entity?

Abstract Background The robotic system has been applied in the treatment of gastric cancer (GC), and the procedure has been found to be safe and feasible. Situs inversus totalis (SIT) is a relatively rare autosomal recessive congenital anomaly. We successfully performed robot-assisted proximal gastrectomy (RAPG) and handsewn double-flap esophagogastrostomy for GC in a patient with SIT. Case presentation A 71-year-old woman was referred to us with an asymptomatic ulcerative lesion in the upper body of the stomach. Computed tomography revealed that she had SIT. She was diagnosed with cT1bN0M0, cStageIA gastric cancer. RAPG with lymph node dissection and handsewn double-flap esophagogastrostomy was performed. Robotic surgery enabled the surgeon to perform the surgery without changing his position and experiencing any confusion resulting from the patient’s reversed anatomy. It took 448 min, and no intraoperative complications occurred. Her postoperative course was uneventful; she was discharged on postoperative day 10. The final pathologic report showed pT1b1N0M0, pStage IA. Conclusions This is the first case describing RAPG with handsewn double-flap esophagogastrostomy for a SIT patient with early GC.

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Simplified Technique of Conventional Cholecystectomy in a Patient with Situs Inversus Totalis: A Case Report from Nepal

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v19i1.40443 ◽

2022 ◽

Vol 19 (1) ◽

pp. 109-110

Author(s):

Suresh Kumar Nag

Keyword(s):

Situs Inversus ◽

Autosomal Recessive ◽

Autosomal Recessive Disorder ◽

Situs Inversus Totalis ◽

Gallbladder Stone ◽

Case Presentation ◽

Obese Female ◽

Normal Gallbladder ◽

Upper Abdominal ◽

Left Subcostal Incision

Introduction: Situs inversus is a rare autosomal recessive disorder occurring in 1:5,000 to 1:20,000 indiviuals. Cholecystectomy is a standard treatment for symptomatic gallbladder stone. We report a case of cholelithiasis in patient with inversus totalis who underwent cholecystectomy. Case presentation: A 48 years old obese female patient with dextrocardia and hypertention presented with a recurrent left upper abdominal pain for two years. Ultrasound abdomen showed gallbladder stone. Conventional cholecystectomy was done with a small left subcostal incision. The postoperative period was uneventful and the patient was discharged on 3rd post operative day. Conclusion: Cholecystectomy is the treatment of choice in patients with a left sided gallbladder stone, like in normal gallbladder and it is safe.

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Situs inversus totalis - a case report

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401765 ◽

2014 ◽

Vol 03 (04) ◽

pp. 220-224

Author(s):

Malamoni Dutta ◽

Joydev Sarma

Keyword(s):

Situs Inversus ◽

Primary Ciliary Dyskinesia ◽

Autosomal Recessive ◽

Situs Inversus Totalis ◽

Medical Attention ◽

Kartagener Syndrome ◽

Live Births ◽

Medical College ◽

Exact Etiology ◽

Ciliary Dyskinesia

AbstractSitus inversus is a congenital positional anomaly characterized by transposition of abdominal viscera and when associated with right sided heart (Dextrocardia) is referred to as Situs inversus totalis. It is not so uncommon congenital positional anomaly but can be a diagnostic problem at times. The case was detected in the Department of Anatomy, Gauhati Medical College during the routine dissection. Situs inversus was first described by Aristotle in animals and by Fabricius in humans. Its incidence has been reported between 1 in 4000 to 20,000 live births. The exact etiology is unknown but Autosomal recessive and X-linked inheritance have been reported. It can also occur in association with syndromes such as Kartagener syndrome or Primary Ciliary Dyskinesia (PCD). Many people with situs inversus totalis are unaware of their unusual anatomy until they seek medical attention for any condition.

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Laparoscopic sleeve gastrectomy in a patient withsitus inversus totalisand Kartagener syndrome: an unusual surgical conundrum

BMJ Case Reports ◽

10.1136/bcr-2019-229550 ◽

2019 ◽

Vol 12 (7) ◽

pp. e229550

Author(s):

Angela Burvill ◽

Ruth Blackham ◽

Jeffrey Hamdorf

Keyword(s):

Bariatric Surgery ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Situs Inversus ◽

Autosomal Recessive ◽

Situs Inversus Totalis ◽

Team Approach ◽

Kartagener Syndrome ◽

Autosomal Recessive Condition

Kartagener syndrome is a rare autosomal recessive condition. Approximately 25% of those withsitus inversus totalissuffer the syndrome. With the rising overall number and indications for bariatric surgery, this condition will be increasingly recognised. We present a case of a 25-year-old woman withSITand Kartagener syndrome who underwent a laparoscopic sleeve gastrectomy. As with all bariatric surgery, a multidisciplinary team approach was important in managing such a case. There were considerable cognitive challenges for the surgical team both preoperatively and during the procedure. The patient tolerated the operation well and was discharged 2 days after the surgery. At 12-months follow-up, the patient had achieved 125% excess weight loss. This case illustrates that an experienced surgeon can safely perform a laparoscopic sleeve gastrectomy on a patient withsitus inversus totalis.

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Pyloric perforation in situs inversus totalis and Ladd’s band with dextrocardia: a collection of rare anomalies and associated operative challenge

International Surgery Journal ◽

10.18203/2349-2902.isj20205908 ◽

2020 ◽

Vol 8 (1) ◽

pp. 382

Author(s):

Tausif Kamal Syed ◽

Ikram Fareed ◽

Jilani Awati ◽

Sajid Mudhol

Keyword(s):

Situs Inversus ◽

Autosomal Recessive ◽

Situs Inversus Totalis ◽

Rare Entity ◽

Fibrous Band ◽

Perforation Peritonitis ◽

Asymptomatic Adult ◽

Normal Life Span ◽

Operative Findings ◽

The Right

Situs inversus totalis with dextrocardia is a rare entity where the liver and gall bladder are on the left side and the spleen on the right. It is an autosomal recessive mode of inheritance and the patients are usually asymptomatic with a normal life span. Ladd’s band on the other hand is a fibrous band of peritoneum lying over the duodenum to the caecum, which usually presents as intestinal malrotation and is most commonly diagnosed and treated with Ladd’s procedure in infancy itself. Asymptomatic adult cases presenting later in life are rarely seen. Here we present a case of a 22-year-old male who presented with symptoms of perforation peritonitis and was diagnosed on clinical and radiological examination to have situs inversus. Intra-operative findings later revealed presence of a Ladd’s band too.

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Laparoscopic Cholecystectomy in Kartagener Syndrome

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1262 ◽

2017 ◽

Vol 51 (4) ◽

pp. 192-194

Author(s):

Rahul Gupta ◽

Harjeet Singh ◽

Ganga R Verma

Keyword(s):

Laparoscopic Cholecystectomy ◽

Laparoscopic Surgery ◽

Magnetic Resonance ◽

Situs Inversus ◽

Autosomal Recessive ◽

Epigastric Pain ◽

Autosomal Recessive Disorder ◽

Situs Inversus Totalis ◽

Kartagener Syndrome ◽

Abdominal Organs

ABSTRACT Kartagener syndrome is a rare autosomal recessive disorder in which there is situs inversus involving abdominal or thoracic viscera or both. Anatomy of the abdominal organs in such a patient is distorted making laparoscopic surgery very difficult. A 45-year-old lady, a known case of Kartagener syndrome, presented with epigastric pain. Ultrasound of abdomen revealed situs inversus with mild hepatomegaly and multiple gallbladder calculi. Magnetic resonance pancreatocholangiography (MRCP) confirmed situs inversus totalis with cholelithiasis and mild central intrahepatic biliary dilatation. Patient was treated successfully with laparoscopic cholecystectomy. How to cite this article Gupta R, Singh H, Verma GR. Laparoscopic Cholecystectomy in Kartagener Syndrome. J Postgrad Med Edu Res 2017;51(4):192-194.

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Laparoscopic Sleeve gastrectomy in Situs Inversus Totalis (video).

10.32512/jmr.1.1.2018/20.23 ◽

2018 ◽

pp. 20-23

Keyword(s):

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Situs Inversus ◽

Autosomal Recessive ◽

Situs Inversus Totalis ◽

Mirror Image ◽

Gastric Sleeve ◽

Normal Anatomy ◽

Laparoscopic Procedures

Situs inversus totalis (SIT) is a rare autosomal recessive entity defined as the transposition of thoracic and intraabdominal organs forming a mirror image to the normal anatomy. Laparoscopic procedures are technically more challenging for the surgeons in case of SIT. We hereby report two cases of successful laparoscopic gastric sleeve in SIT patients.

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