2001, Number 3
Cholecystectomy and appendectomy by laparoscopy in a patient with situs inversus totalis. A case report and review of the literature
PDF size: 69.18 Kb.
ABSTRACTAim: To report a case of a patient with cholecystitis and situs inversus totalis treated by laparoscopy. Design: case report. Institution: Texas Endosurgery Institute. San Antonio, Texas. Case Report: A 25-year-old female was referred with a 3-month history of colicky abdominal pain, localized to the left upper quadrant, which progressively worsened and became constant. The physical examination revealed diffuse pain in the epigastrium, without signs of peritoneal irritation. The abdominal US showed cholelithiasis and the gallbladder was localized in the left hypochondrium. The white cell count was 8,500/mL and liver function tests were normal. Standard laparoscopic cholecystectomy and appendectomy with a mirror-image surgical approach were performed successfully without complication. Conclusion: Cholelithiasis occurring with situs inversus totalis is a rare condition which is safely and effectively treated by laparoscopy. Meticulous attention to detailed anatomical dissection and cholangiography are recommended.
Mayo CW, RiceTG. Situs inversus totalis. A statistical review of data on seventy six cases with special reference to disease of the biliary tract. Arch Surg 1949; 58: 724-730.
Sandro C, Raffaele DV, Roberto Z. Suspected appendicitis in situs inversus totalis. An indication for a laparoscopic approach. Surgical Laparoscopy and Endoscopy 1998; 8: 393-4.
Djohan RS, Rodriguez HE, Wiesman IM, Unti JA, Podbielski FJ. Laparoscopic cholecystectomy and appendectomy in situs inversus totalis. JSLS 2000; 4: 251-4.
Demetriades H, Botsios D, Dervenis C, Evagelou J, Agelopoulos S, Dadoukis J. Laparoscopic cholecystectomy with symptomatic cholelithiasis and situs inversus totalis. Dig Surg 1999; 16: 519-21.
Huang SM, Chau GY, Lui WY. Laparoscopic cholecystectomy for cholelitiasis in a patient with situs inversus totalis. Endoscopy 1992; 24: 802-3.
Goh P, Tekant Y, Shang NS, Ngoi SS. Laparoscopic cholecystectomy in a patient with empyema of the gallbladder and situs inversus. Endoscopy 1992; 24: 799-800.
Wong J, Tang CN, Chau CH, Luk YW, Li MKW. Laparoscopic cholecystectomy and exploration of common bile duct in a patient with situs inversus. Surgical Endoscopy 2001; 15: 218.
McDermott JP, Caushaj PF. ERCP and laparoscopic cholecystectomy for cholangitis in a 66-year-old male with situs inversus. Surgical Endoscopy 1994; 8:1227-9.
Idu M, Jakimowicz J, Iuppa A, Cuschieri A. Hepatobiliary anatomy in patients with transposition of gallbladder: implications for safe laparoscopic cholecystectomy. Br J Surg 1996; 83:1442-3.