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Laparoscopic cholecystectomy in situs inversus totalis  [cached]
Hamdi Jamal,Hamdan Omar
Saudi Journal of Gastroenterology , 2008,
Abstract: Situs inversus totalis is a rare defect with genetic predisposition that may present difficulties in the diagnosis and management of abdominal pathology due to mirror-image anatomy. Occasionally, these patients may present with acute cholecystitis. Laparoscopic cholecystectomy is the standard treatment for symptomatic cholelithiasis; however, the technique has to be varied for the treatment of situs inversus totalis. To the best of our knowledge, we report the first case in Saudi Arabia of a successful laparoscopic cholecystectomy in a patient with situs inversus totalis. The technique is presented and the pitfalls are discussed with a review of the relevant literature.
Situs inversus totalis with carcinoma of gastric cardia: a case report  [cached]
Ke Pan,Dewu Zhong,Xiongying Miao,Guoqing Liu
World Journal of Surgical Oncology , 2012, DOI: 10.1186/1477-7819-10-263
Abstract: Situs inversus is an uncommon anomaly with rare incidence. Some cases of situs inversus totalis have been described with different types of associations. Here we report a case of situs inversus with carcinoma of the gastric cardia.
Laparoscopic cholecystectomy in situs inversus totalis: a case report
Damian McKay, Geoffrey Blake
BMC Surgery , 2005, DOI: 10.1186/1471-2482-5-5
Abstract: A 32 year old female presented to our department with epigastric pain radiating through to the back. A diagnosis of acute cholecystitis in a patient with situs inversus totalis was made following clinical examination and radiological investigation. Laparoscopic cholecystectomy was subsequently performed and the patient made an uneventful recovery.Situs inversus presenting with acute cholecystitis is very rare. The surgeon must appreciate that care should be taken to set up the operating theatre in the mirror image of the normal set-up for cholecystectomy, and that right handed surgeons must modify their technique to adapt to the mirror image anatomy.In 1600 the first known case of situs inversus in humans was reported by Fabricius [1]. The incidence is thought to be in the region of 1:5000 to 1:20000 [2]. The condition may affect the thoracic organs, abdominal organs or both. It is associated with a number of other conditions such as Kartagener's (bronchiectasis, sinusitis, situs inversus) and cardiac anomalies. There is no current evidence that situs inversus predisposes to cholelithiasis [3].Since Mouret first performed it in 1987, laparoscopic cholecystectomy has become the standard operative procedure for gallbladder disease. It is associated with reduced hospital stay, fewer respiratory complications, less pain and a faster return to work.A thirty two year old female was admitted with a three hour history of epigastric pain radiating into her back in keeping with biliary colic. She had vomited a number of times. In the previous week she had two episodes of a similar nature.On examination there was no jaundice or pyrexia. The apex beat was in the right fifth intercostal space, midclavicular line. She had epigastric tenderness but was not tender in the right or left upper quadrants. Her white cell count and amylase level was normal but her C-reactive protein level (CRP) was elevated at 290 mg/L. An electrocardiograph showed right axis deviation and right ventricu
Hepatectomia por linfangioma em situs inversus totalis : relato de caso
Soares Júnior, Ant?nio Wellington Lima;Tajra, Carlos Eduardo Feitosa;Soares, Vitor Yamashiro Rocha;Soares, Jefferson Lemos;Costa, Jerri Alexandre;
Revista do Colégio Brasileiro de Cirurgi?es , 2011, DOI: 10.1590/S0100-69912011000600016
Abstract: we present a case of hepatectomy in a patient with liver's lymphangioma associated with situs inversus totalis. the first case of medical literature.
Laparoscopic cholecystectomy, in a patient with situs inversus totalis
. Komborozos V.,Papoudos M.,Yannopoulos P.
Annals of Gastroenterology , 2007,
Abstract: SUMMARY We present an elderly patient with known dextrocardia and pain in the left upper quadrant associated with high fever, chills and vomiting and a palpable mass in the same region. The abdominal ultrasound confirmed the diagnosis of situs inversus with the liver and gallbladder on the left side and the spleen on the right. The gallbladder was distended with thick shaggy walls and contained a lot of large gallstones in the neck. The patient was treated via laparoscopic cholecystectomy and the postoperative recovery was uneventful. Key words: Situs inversus totalis, laparoscopic cholecystectomy, empyema of the gallbladder
Laparoscopic Nissen fundoplication in situs inversus totalis: Technical and ergonomic issues  [cached]
Khandelwal Radha,Karthikeayan S,Balachandar T,Reddy Prasanna
Journal of Minimal Access Surgery , 2010,
Abstract: We report a laparoscopic Nissen fundoplication for gastroesophageal reflux disease (GERD) in a patient with situs inversus totalis (SIT). A 34-year-old man was diagnosed with SIT on performing chest X-ray and abdominal sonography as a routine preoperative investigations. He presented with chronic gastro-esophageal reflux disease (GERD) inadequately controlled by medications. The laparoscopic procedure was performed using five ports placed in a mirror-image configuration and with the patient in the modified lithotomy position. Few technical difficulties were encountered during the operation. The position of the primary surgeon, working between the lower limbs of the patient as in case of standard fundoplication, was considered most prudent position to the success of this case. In SIT, this position provides the least visual disorientation from the reversed abdominal organs. We recommend that preoperative detection of SIT is essential to understand the symptomatology of the patient and for planning of any upper abdominal laparoscopic procedure.
Cholecystectomy in situs inversus totalis: a laparoscopic approach
Dan Eisenberg
International Medical Case Reports Journal , 2009, DOI: http://dx.doi.org/10.2147/IMCRJ.S7702
Abstract: lecystectomy in situs inversus totalis: a laparoscopic approach Case report (4873) Total Article Views Authors: Dan Eisenberg Published Date October 2009 Volume 2009:2 Pages 27 - 29 DOI: http://dx.doi.org/10.2147/IMCRJ.S7702 Dan Eisenberg Department of Surgery, Palo Alto VA Health Care System and Stanford School of Medicine, Palo Alto, CA, USA Purpose: To report and describe a safe approach to laparoscopic cholecystectomy in patients with situs inversus totalis. Methods: We present the case of a 61-year-old male who was diagnosed with gallstones and situs inversus totalis during work-up for epigastric pain. Laparoscopic cholecystectomy was performed in mirror-image to the standard approach, with the surgeon standing on the patient’s right side. In order to maintain orientation and safety during the operation, anatomical structures were spatially related to each other in a “medial” and “lateral” manner, which are preserved in situs inversus; rather than “left” and “right” which are reversed. Results: The duration of the operation was 85 minutes, which is slightly longer than our standard laparoscopic cholecystectomy. Nonetheless, the patient was discharged on the morning following surgery, which is comparable to other patients undergoing laparoscopic cholecystectomy. He was seen in follow-up on postoperative day 14 and was doing very well. There were no postoperative complications. Conclusion: Laparoscopic cholecystectomy can be performed safely in patients with situs inversus totalis. Careful attention to unfamiliar anatomic relationships is important. Approaching the anatomy in terms of medial and lateral structures, a relationship that is preserved, is helpful to complete the procedure safely.
Cholecystectomy in situs inversus totalis: a laparoscopic approach  [cached]
Dan Eisenberg
International Medical Case Reports Journal , 2009,
Abstract: Dan EisenbergDepartment of Surgery, Palo Alto VA Health Care System and Stanford School of Medicine, Palo Alto, CA, USAPurpose: To report and describe a safe approach to laparoscopic cholecystectomy in patients with situs inversus totalis.Methods: We present the case of a 61-year-old male who was diagnosed with gallstones and situs inversus totalis during work-up for epigastric pain. Laparoscopic cholecystectomy was performed in mirror-image to the standard approach, with the surgeon standing on the patient’s right side. In order to maintain orientation and safety during the operation, anatomical structures were spatially related to each other in a “medial” and “lateral” manner, which are preserved in situs inversus; rather than “left” and “right” which are reversed.Results: The duration of the operation was 85 minutes, which is slightly longer than our standard laparoscopic cholecystectomy. Nonetheless, the patient was discharged on the morning following surgery, which is comparable to other patients undergoing laparoscopic cholecystectomy. He was seen in follow-up on postoperative day 14 and was doing very well. There were no postoperative complications.Conclusion: Laparoscopic cholecystectomy can be performed safely in patients with situs inversus totalis. Careful attention to unfamiliar anatomic relationships is important. Approaching the anatomy in terms of medial and lateral structures, a relationship that is preserved, is helpful to complete the procedure safely.Keywords: cholecystectomy, laparoscopic, situs inversus, mirror-image
A case of cholelithiasis in a patient with situs inversus totalis  [cached]
Alper Akcan,H?z?r Aky?ld?z,Fatih Ekici,Yücel Ar?ta?
Erciyes Medical Journal , 2007,
Abstract: Situs inversus is a rare condition in which the major organs are reversed from left to right. Situs inversus presenting with cholelithiasis is very rare. We suggest that laparoscopic cholecystectomy is a safe and effective choice in the treatment of the cholelithiasis, and also for situs inversus patients. However the surgeon must be aware of the details of left-right reversal and associated abnormalities. In this article we report a case of cholelithiasis in a patient with situs inversus totalis.
Emergency Cholecystectomy in Situs Inversus Totalis: Report of a Case  [cached]
Dr. G M Naikoo,Dr. Imtiaz Wani,Dr. Imran Mir,Dr. Fozia Jan
Internet Journal of Medical Update - EJOURNAL , 2008,
Abstract: Situs inversus totalis is a rare anomaly with a genetic predisposition, characterized by transposition of organs to the opposite side of the body. The condition may present difficulties in the management of abdominal pathologies and if undetected can create a diagnostic puzzle. Herein we report a case of situs inversus totalis with acute cholecystitis and the patient underwent successful emergency open cholecystectomy.
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