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[Laparoscopic cholecystectomy in situs viscerum inversus totalis: technical note]
G G A Romano1, G Grande, F Romano
1ASL AV1 Ariano Irpino, Ospedale G. Criscuoli, Sant'Angelo dei Lombardi (AV), Divisione di Chirurgia.
Il Giornale Di Chirurgia
|September 9, 2009
Summary
A patient with dextrocardia and situs viscerum inversus totalis presented with biliary colic. Laparoscopic cholecystectomy successfully treated the gallstones causing the colic.
Area of Science:
- Medicine
- Radiology
- Surgery
Background:
- Dextrocardia is a rare congenital condition where the heart is on the right side of the chest.
- Situs viscerum inversus totalis is a condition where all visceral organs are mirrored from their normal positions.
- Biliary colic is a common surgical emergency often caused by gallstones.
Observation:
- A patient with known dextrocardia presented to the emergency room with symptoms of biliary colic.
- Electrocardiogram (ECG) and chest X-ray confirmed dextrocardia.
- Abdominal ultrasonography and CT scan revealed situs viscerum inversus totalis and cholecystolithiasis.
Findings:
- The patient's biliary colic was attributed to cholecystolithiasis (gallstones) in the context of situs viscerum inversus totalis.
- Diagnostic imaging played a crucial role in identifying the anatomical anomaly and the cause of colic.
- Laparoscopic cholecystectomy was successfully performed to remove the gallbladder.
Implications:
- This case highlights the importance of considering anatomical variations in diagnosing and managing abdominal emergencies.
- Surgical planning and execution require careful consideration of situs inversus totalis to avoid complications.
- Laparoscopic cholecystectomy is a feasible and effective treatment for gallstones even in patients with complex visceral arrangements.