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Small bowel obstruction with situs inversus abdominalis: A case report
1Department of General Surgery, Armadale-Kelmscott Memorial Hospital, Australia.
International Journal of Surgery Case Reports
|August 1, 2020
Summary
Situs inversus abdominalis (SIA) can cause rare small bowel obstructions (SBO) in adults. This case highlights successful surgical management without bowel resection, emphasizing early intervention for congenital anomalies.
Area of Science:
- Gastroenterology
- Surgical Case Reports
- Congenital Anomalies
Background:
- Situs inversus abdominalis (SIA) is a rare condition associated with intestinal malrotation in children.
- Acute surgical emergencies in adults with SIA are exceptionally uncommon.
- Previous literature documents only two cases of small bowel obstruction (SBO) secondary to SIA.
Observation:
- A 38-year-old female with SIA and a history of omphalocele repair presented with SBO.
- The patient failed conservative management, necessitating surgical intervention.
- Surgical treatment involved laparotomy and adhesiolysis without the need for intestinal resection.
Findings:
- This is the third reported case of SBO secondary to SIA in the literature.
- Unlike previous cases with a 50% mortality rate and bowel resection, this patient avoided bowel ischemia.
- Successful outcome attributed to early presentation, prompt imaging, and meticulous surgical planning.
Implications:
- This case underscores the importance of a low threshold for imaging and intervention in patients with congenital anomalies presenting with acute surgical emergencies.
- Emphasizes the critical role of detailed pre-operative planning and a senior surgeon-led approach for optimal patient outcomes.
- Highlights the potential for successful non-resectional surgical management of SBO in SIA patients with early diagnosis and multidisciplinary care.
