Cholecystectomy under regional anesthesia in a patient with total Kartagener's syndrome

A 41-year-old woman with complete Kartagener's syndrome developed cholecystitis in a left-sided gall bladder. Bilateral diffuse bronchiectasis ruled her unfit for general anesthesia; chronic cough, copious expectoration and dyspnea prevented her from lying down supine for more than a few minutes. Successful cholecystectomy was performed in a semi-reclined position using thoracic epidural anesthesia, the anatomy being the mirror image of that of a gall bladder in normal position. The gall bladder was full of stones and operative cholangiogram revealed a normal but transposed biliary system.