Laparoscopic cholecystectomy in situs inversus totalis: a case report and review of the surgical techniques
Abstract
Background: Situs inversus totalis is a rare condition characterized by the mirror image transposition of internal organs. Diagnosis may be difficult when the patient has situs inversus as the presenting symptoms may lead to confusion. Laparoscopic cholecystectomy becomes more technically demanding for surgeons due to the modification and reorientation of the surgical procedure.
Case study: A 46-year-old male patient presented with left upper quadrant pain, nausea, and vomiting. Physical examination revealed mild tenderness to palpation in the left upper quadrant region. Murphy’s sign was negative and the laboratory results were normal. Abdominal ultrasonography revealed situs inversus and a single 36-mm gallstone. The patient underwent laparoscopic cholecystectomy and the postoperative course was uneventful.
Conclusion: Due to the reversal of internal organs in patients with situs inversus totalis, laparoscopic cholecystectomy becomes technically demanding in patients who present with cholelithiasis. Various techniques have been suggested to minimize reorientation issues during surgery.
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