• cholelithiasis
• laparoscopy
• situs inversus

• Humans
• Female
• Aged
• Cholecystectomy, Laparoscopic/methods
• Situs Inversus/complications
• Situs Inversus/surgery
• Cholecystolithiasis/surgery
• Cholecystolithiasis/complications

• Humans
• Situs Inversus/complications
• Situs Inversus/surgery
• Laparoscopy/methods
• Colectomy/methods
• Colon, Sigmoid/surgery
• Colorectal Neoplasms/surgery
• Colorectal Neoplasms/complications
• Sigmoid Neoplasms/surgery
• Sigmoid Neoplasms/complications
• Male
• Female
• Middle Aged

• a 3-port system
• minimally invasive cardiac surgery
• mitral valve replacement
• situs inversus totalis
• totally 3D endoscopic surgery

• Acute appendicitis
• case report
• perforation
• situs inversus totalis

• kidney transplant
• laparoendoscopic single site surgery
• laparoscopic donor nephrectomy
• nephrectomy
• situs inversus totalis

• Adolescent
• Case report
• Dextrocardia
• Education
• Situs inversus

• Adolescent
• Levocardia
• Situs inversus
• Situs inversus with levocardia

• Child
• Male
• Adolescent
• Humans
• Levocardia
• Situs Inversus/complications
• Situs Inversus/diagnostic imaging
• Heart Defects, Congenital
• Viscera
• Abdomen

• cholecystitis
• general surgery
• situs inversus totalis

• anatomic imaging
• bronchoscopy
• critical care and hospital medicine
• pneumology
• s: embryology
• situs-inversus-totalis

• Acute appendicitis
• Kartagener syndrome
• Laparoscopic appendectomy
• Midgut malrotation
• Situs viscerum inversus

• Adult
• Intestinal Volvulus
• Diagnosis, Differential
• Child
• Female
• Humans
• Digestive System Abnormalities
• Radiography
• Aged
• Middle Aged
• Acute Disease
• Male
• Young Adult
• Aged, 80 and over
• Adolescent

• not receive

Situs inversus totalis represents an unusual anomaly characterized by a mirror-image transposition of the abdominal and thoracic viscera. It often occurs concomitantly with other disorders, hindering the diagnosis and management of abdominal pathology. The relationship between situs inversus totalis and cancer remains unclear.

We describe a 79-year old Japanese female with situs inversus totalis who presented with obstructive jaundice. Imaging and endoscopic examinations showed a mass in the distal common bile duct, which was identified as an adenocarcinoma on biopsy. The patient was successfully treated by cephalic pancreaticoduodenectomy and the histological diagnosis was adenosquamous cell carcinoma. Ten months following surgery, the patient received chemotherapy and radiotherapy due to the presence of liver metastasis.

The occurrence of an adenosquamous carcinoma of the bile duct in a patient with situs inversus totalis is an extremely rare coincidence. In this setting, when the tumor is resectable, surgical management should be considered without contraindication and must be preceded by careful preoperative staging.

•

Situs inversus totalis (SIT) is a rare congenital condition characterized by a mirror-image transposition of both the abdominal and thoracic viscera.

• Adenosquamous carcinoma
• Bile duct carcinoma
• Case report
• Situs inversus totalis
• Surgical management

• Abdominal Pain/etiology
• Adolescent
• Appendicitis/diagnosis
• Appendicitis/surgery
• Diagnostic Tests, Routine
• Emergency Medical Services
• Humans
• Male
• Tomography, X-Ray Computed

• endoscopic
• gastrostomy
• inversus
• situs
• totalis

Coexistence of situs inversus totalis and ovarian serous cystadenoma in pubertal girls is extremely rare. It is important to preserve ovarian hormonal physiology and fertility if it is detected in the pubertal period.

A 16-year-old girl presented with abdominal distension and pain. Radiological evaluation revealed a huge abdominal cystic mass and situs inversus totalis. In laparotomy, unilateral salpingoophorectomy and total cystectomy were performed on the ovarian cystic mass. It was confirmed as serous cystadenoma in pathological evaluation.

This is the first reported case in the literature of situs inversus totalis with a huge ovarian serous cystadenoma.

• ovarian serous cystadenoma
• situs inversus totalis
• surgery

Situs inversus totalis is a rare anatomical variation of both the thoracic and the abdominal organs. Common bile duct strictures can be caused by malignant and benign diseases as well. 7–18% of the latter ones are 'malignant masquerade’ cases, as pre-operative differentiation is difficult.

We present the case of a 68y male patient with known situs inversus totalis and a recent onset of obstructive jaundice caused by a malignant behaving common bile duct stricture. Technically difficult endoscopic retrograde cholangiopancreatography, brush cytology, magnetic resonance cholangiopancreatography, endoscopic ultrasound, and percutaneous transhepatic drainage with stent implantation were performed for proper diagnosis. Cholecystectomy, common bile duct resection with hilar lymphadenectomy, and hepatico-jejunostomy have been performed following multidisciplinary consultation. The final histology report did not confirm any clear malignancy, the patient is doing well.

In situs inversus patients, both diagnostic and therapeutic procedures can lead to various difficulties. Benign biliary strictures are frequently misdiagnosed preoperatively as cholangiocellular carcinoma. Surgery is usually unavoidable, involving a significant risk of complications. The co-existence of these two difficult diagnostic and therapeutic features made our case challenging.

The online version contains supplementary material available at 10.1186/s12893-021-01155-w.

• Common bile duct
• Klatskin tumor
• Obstructive jaundice
• Perihilar cholangiocarcinoma
• Situs inversus

Situs inversus totalis (SIT) refers to a mirror-image reversal of the internal organ position. The coexistence of abdominal aortic aneurysm and SIT is extremely rare; very short series have been reported; therefore its prevalence has never been estimated. The presence of anatomical anomalies could increase operative risk. The authors describe a case of successfully repaired pararenal abdominal aortic aneurysm with a right retroperitoneal approach in situs inversus totalis.

• pararenal aneurysm
• right retroperitoneal approach
• situs viscerum inversus

•

Cardiac surgery in a patient with situs inversus totalis poses technical challenges.

Situs inversus totalis (SIT) is an uncommon congenital condition characterized by total transposition of abdominal and thoracic viscera. Performing minimally invasive cardiac surgery on individuals with SIT requires different surgical planning because of the unfamiliar positions of the heart and great vessels.

A 52-year-old female was admitted to our center with palpitations and dyspnea on exertion. Chest X-ray showed dextrocardia. Echocardiography and chest computerized tomography (CT) revealed SIT with severe rheumatic mitral valve disease.

Pre-operative three-dimensional (3D) chest CT reconstruction was helpful in surgical planning and management of cardiopulmonary bypass (CPB). Mitral valve replacement and concomitant atrial fibrillation (AF) ablation using radiofrequency (RF) energy via left mini-thoracotomy was successfully performed on the patient.

Minimally invasive approach can be safely and effectively employed in patients with SIT.

• Atrial fibrillation ablation
• Case report
• Minimally invasive cardiac surgery
• Radiofrequency
• Situs inversus totalis

•

We report the very first case Management of gastric perforation in situs inversus totalis in a 45-year-old adult.

Situs inversus is a rare congenital malformation often discovered during childhood. It can cause diagnosis errors in adulthood. Its association with gastric perforation is an extremely rare event in the literature. Its diagnosis is made by an adequate morphological assessment.

A 45-years-old man, was admitted to the surgical emergency department for generalized acute abdominal pain initially sitting in the right hypochondrium, accompanied by bilious vomiting and a stop in intestinal transit, progressing for 48 h. He had no known surgical history. The clinical examination noted an altered general state (WHO III) and a peritoneal syndrome. A diagnosis of generalized acute peritonitis has been made. An x-ray of the abdomen without preparation revealed a bilateral pneumoperitoneum with a cardiac point on the right. The thoraco-abdomino-pelvic CT scan confirmed the diagnosis. After resuscitation, the patient underwent a laparotomy with gastroraphy and appendectomy. The postoperative follow-ups were without an uneventful, over a 15-month follow-up.

Situs inversus totalis is an uncomon event. Its exact etiology is still unknown. Some authors incriminate an autosomal recessive gene. In our context, its diagnosis is a surprise. Its revelation by gastric perforation is an extremely rare event. Surgical treatment must be performed early. Prognosis is generally better.

In developing countries the diagnosis of situs inversus is a surprise during a pathology which led the patient to a medical consultation. CT-scan is one of the key paraclinic exams for its diagnosis.

• Burkina Faso
• CT-scan
• Gastric perforation
• Situs inversus totalis

• 3D printed model
• heterotaxy
• liver transplantation

• Case report
• Laparoscopy
• Rectal neoplasm
• Situs inversus totalis
• Three-dimensional reconstruction

• Bile duct stones
• ERCP
• Situs inversus

• Apple-peel atresia
• Complex jejunal atresia
• Polysplenia
• Situs inversus

We report a case of a 43-year-old man with situs inversus and dextrocardia who was admitted with syncope in the setting of complete atrioventricular block. The complex anatomy poses a considerable challenge to transvenous permanent pacemaker implantation. We employed a novel technique using vascular ultrasound and agitated saline solution to assist with lead positioning. This technique could be useful in pediatric populations or younger patients, in whom the use of ionizing radiation is an important issue.

• Bubble contrast
• congenital cardiac disease
• dextrocardia
• pacemaker implantation
• vascular ultrasound

Situs inversus totalis (SIT) is a very rare condition that is seen at a rate of one in about 6000–8000 births.

To offer a general view on the coexistence of SIT and gastric cancer, accompanied by a literature review.

Within the scope of this study, the case of a patient with gastric adenocarcinoma and SIT has been presented. Previous research on gastric cancer cases with SIT was reviewed through a comprehensive search of the PubMed, Medline, and Google Scholar databases. The keywords used to conduct this research were “situs inversus totalis and gastric cancer,” “situs inversus totalis and gastric malignant,” and “situs inversus totalis and gastric resection.” The database search covered English studies published between 2000 and 2016.

The results of our literature review revealed 20 studies of patients with gastric cancer and SIT, and 21 related cases. Overall, 12 of the patients were male, 9 were female, and their mean age was 61.8 ±10.97 years. The vascular assessment data showed that three out of the 13 mentioned cases had vascular anomalies. Eleven of the patients had laparoscopic resections, and one of the patients that had a surgical procedure exhibiting a postoperative mechanical obstruction.

The coexistence of SIT and gastric cancer is a very rare condition, and a careful preoperative radiological assessment should be conducted because there can be accompanying vascular anomalies. Laparoscopies and robotic surgeries can be performed for suitable patients at experienced centres, consistent with oncological principles.

• gastrectomy
• gastric cancer
• situs inversus totalis

• diagnose
• pancreatic neoplasms
• situs inversus totalis
• solid pseudopapillary pancreatic tumor
• splenectomy
• surgery

• Diagnosis, Differential
• Female
• Humans
• Middle Aged
• Pancreatic Neoplasms/complications
• Pancreatic Neoplasms/diagnostic imaging
• Pancreatic Neoplasms/surgery
• Situs Inversus/complications
• Situs Inversus/diagnostic imaging

• Cholangiography
• Choledochal cyst
• Hepaticojejunostomy
• Situs inversus totalis

The association of neonatal intestinal obstruction with situs inversus totalis is extremely rare with only few cases reported in the literature to date. This association poses dilemmas in management. We present two such cases (of Indian origin), and briefly discuss the pertinent literature and measures to prevent unfavorable outcome.

Case 1: a 1-month-old preterm (1300 g) male neonate belonging to Hindu (Indian) ethnicity presented with recurrent bile-stained vomiting, non-passage of stools and epigastric fullness. A babygram and upper gastrointestinal contrast studies revealed situs inversus and suggested proximal jejunal obstruction with midgut volvulus. Exploration confirmed situs inversus totalis along with reverse rotation and midgut volvulus. There was a small gangrenous area in the proximal jejunal loop. A Ladd’s procedure, resection of the gangrenous jejunal loop, and jejunojejunal anastomosis was performed. Note was made of the unusual appearance of the intestines suggestive either of fibrous or fatty infiltration. Postoperatively, our patient developed septicemia and died.

Case 2: a 4-day-old female neonate belonging to Hindu (Indian) ethnicity, small (1320 g) for gestation, presented with history of non-passage of meconium since birth, refusal to accept feeds, and episodes of recurrent bilious vomiting with abdominal distension. A plain radiogram revealed situs inversus and proximal jejunal obstruction. Ultrasonography of her abdomen revealed renal dysplastic changes in both her kidneys. Laparotomy confirmed multiple jejunoileal atresias with situs inversus totalis. Resection anastomoses was performed for multiple atresias. Our patient passed a few pellets of meconium stools postoperatively; feeds were started gradually on the sixth day. Our patient gradually developed oliguria and renal failure, followed by respiratory distress and generalized edema requiring ventilatory support. She died later due to multiorgan failure.

Clinicians should have high index of suspicion for malrotation with midgut volvulus or intestinal atresias in neonates of situs inversus presenting with bilious vomiting. The surgical treatment should follow the same surgical principles. In situs inversus, because of transposition of viscera, midgut volvulus may occur in an anticlockwise direction, hence derotation is performed clockwise. Prognosis was poor in our series because of low birth weight, late presentation, presence of gangrenous locus in the small bowel and development of septicemia in our first case and multiorgan fibrosis/dysplasia in our second case. Early diagnosis and timely referral is paramount for favorable outcome.

• Association
• Jejunoileal atresia
• Malrotation
• Midgut volvulus
• Neonatal intestinal obstruction
• Situs inversus totalis

• anatomic variation
• d2 lymph node dissection
• gastric cancer
• robot surgery
• situs inversus totalis
• total gastrectomy

• Adenocarcinoma in Situ/pathology
• Adenocarcinoma in Situ/physiopathology
• Adenocarcinoma in Situ/surgery
• Computed Tomography Angiography/methods
• Digestive System Abnormalities/diagnosis
• Esophagogastric Junction/pathology
• Gastrectomy/methods
• Humans
• Laparoscopy/methods
• Male
• Middle Aged
• Preoperative Care/methods
• Robotic Surgical Procedures/methods
• Situs Inversus/diagnosis
• Situs Inversus/physiopathology
• Stomach Neoplasms/pathology
• Stomach Neoplasms/physiopathology
• Stomach Neoplasms/surgery
• Treatment Outcome
• Vascular Malformations/diagnosis

Situs inversus totalis (SIT) is a rare congenital anomaly that refers to a completely reversed location of the abdominal and thoracic organs. We report the case of 50-year-old man with gastric cancer and SIT who was diagnosed during a screening esophagogastroduodenoscopy. A chest X-ray, abdominopelvic computed tomography, and ¹⁸F-fluoro2-deoxyglucose-D-glucose-positron emission tomography scans revealed SIT. We performed a radical subtotal gastrectomy with D2 lymph node dissection. Advanced surgical skill is required to perform a precise lymphadenectomy in a patient with SIT by visualizing the exact mirror image of the anatomy during the operation. The patient had an uneventful intra- and postoperative course and was followed up at the outpatient department without any evidence of recurrence. In conclusion, surgery in a patient with gastric cancer and SIT can be safely performed by paying attention to the inverted anatomic structures during the operation.

• Congenital anomaly
• Situs inversus totalis
• Stomach cancer

Situs inversus totalis (SIT) is a rare congenital condition characterized by a complete transposition of thoracic and abdominal organs. Here, we present two successful cases of left thoracoscopic esophagectomy in the prone position for SIT-associated esophageal cancer.

Our first case was of an 82-year-old man who underwent a left thoracoscopic esophagectomy in the prone position, followed by hand-assisted laparoscopic gastric mobilization. Surgical duration and blood loss were 661 min and 165 g, respectively. His postoperative course was uneventful. The second case was of a 66-year-old man who underwent a left thoracoscopic esophagectomy in the prone position, followed by gastric mobilization via laparotomy owing to a concomitant intestinal malrotation and polysplenia. Surgical duration and blood loss were 637 min and 220 g, respectively. We trained for the surgical procedures preoperatively using left-inverted and right-inverted thoracoscopic surgical videos of patients with normal anatomy.

Surgical procedures in SIT patients are challenging owing to their mirrored anatomy. Recognition　of their　variations　is　thus important to　avoid　intraoperative accidental injuries. Left-inverted and right-inverted thoracoscopic surgical videos of patients with normal anatomy were found to be useful for image training prior to the actual surgery.

Thoracoscopic surgical treatment for esophageal cancer associated with SIT in the prone position can be performed safely, similar to the manner performed for thoracoscopic surgery in the right decubitus position, or surgery via an open thoracotomy. Gastric mobilization via laparotomy should be considered in patients associated other anatomic variations.

• Intestinal malrotation
• Laparoscopy
• Polysplenia
• Thoracoscopy
• Video

• Aged
• Cholecystectomy, Laparoscopic/methods
• Cholecystitis/diagnosis
• Cholecystitis/etiology
• Cholecystitis/physiopathology
• Cholecystitis/surgery
• Cholecystolithiasis/complications
• Chronic Disease
• Female
• Humans
• Intraoperative Care/methods
• Situs Inversus/diagnosis
• Situs Inversus/physiopathology
• Tomography, X-Ray Computed/methods
• Treatment Outcome

Introduction: Situs inversus totalis is an uncommon anomaly which exist a complete transposition of organs and it’s occasionally associated with congenital heart diseases, such as tetralogy of fallot. Pheochromocytoma is a rare neuroendocrine tumor with an annual incidence of 2-8 cases per million people and for years has been studied its relationship with the hypoxic pathway.

Case Report: A 29 year old male with a history of tetralogy of fallot corrected at 10 years and situs inversus totalis. He was admitted to hospital with a progressive story of four months of constipation, palpitations, headache, dyspnea and sweating. Physical examination revealed a thinned man with peripheral cyanosis, clubbing and signs of decompensated congestive heart failure as hepatomegaly, legs edema, multifocal systodiastolic murmurs, abdominal distension and jugular venous distention. The echocardiogram shows severe right ventricular dysfunction and severe pulmonary hypertension. Furthermore, abdominal computed tomography shows right adrenal mass. Elevated metanephrines and catecholamines confirmed the diagnosis of pheochromocytoma. Surgical removal is decided and preoperative management begins with alpha-adrenergic blockade, however the patient had a hemodynamic decompensation with an unfavorable evolution.

Discussion: In conclusion, there are few reports of cyanotic congenital heart disease with pheochromocytoma. Several studies show a significant association between both of them due to chronic hypoxia leads sustained hyperresponsiveness in adrenal medulla and it would cause the tumor. Special preoperative management of pheochromocytoma is recommended when there underlying heart disease and congestive heart failure. We present the first international report of tetralogy of fallot and pheochromocytoma in a patient with situs inversus totalis.

• Congenital Heart Defects
• Hypoxia
• Pheochromocytoma
• Situs Inversus
• Tetralogy of Fallot

• Complete situs inverse
• Gastrointestinal stromal tumor
• Laparoscopic and endoscopic cooperative surgery