Laparoscopic hemicolectomy in a patient with situs inversus totalis

As among persons with normal anatomy, occasional patients with situs inversus develop malignant tumors. Recently, several laparoscopic operations have been reported in patients with situs inversus. We describe laparoscopic hemicolectomy with radical lymphadenectomy in such a patient. Careful consideration of the mirror-image anatomy permitted safe operation using techniques not otherwise differing from those in ordinary cases. Thus, curative laparoscopic surgery for colon cancer in the presence of situs inversus is feasible and safe.     

Myocardial revascularization in a patient with situs inversus totalis

We report the case of a patient with dextrocardia and situs inversus totalis associated with obstructive coronariopathy in the anterior and posterior descending arteries, right coronary artery, first diagonal branch and left marginal branch. The patient underwent coronary artery bypass grafting surgery. This surgery has been rarely reported in literature and we found only one similar case in the national medical literature. The myocardial revascularization was carried out with the right mammary artery for the anterior descending artery. The saphenous vein anastomosed the aorta to the right coronary artery, left marginal branch, fist diagonal branch and posterior descending artery. The surgery was performed with extracorporeal circulation.     

Laparoscopic cholecystectomy in a patient with situs inversus totalis

INtroDUCtIoNSitus inversus totalis (SIT) is a very uncommon entity. It was first reported by Fabricius in 1600[1]. The incidenceis thought to be in the range of 1:10 000 to 1:20 000[2]. Transposition of the organs may also affect thoracic organs, besides …     

Therapeutic endoscopic retrograde cholangiopancreatography in a patient with situs inversus viscerum

Situs inversus viscerum(SIV)is a rare congenitalcondition characterized by complete transposition of all viscera.This anatomical pathology makes endoscopic retrograde cholangiopancreatography(ERCP)technically difficult.We report a new case of a 70-year-old Chinese male with total SIV who had obstructive jaundice.Magneticresonance cholangiopancreatography demonstrated a number of stones in the gallbladder and common bile duct(CBD).Therapeutic ERCP was performed to relieve biliary obstruction and remove the CBD stones.This procedure started with the patient in a supine position and the endoscopist at the left side of the table.When the papilla was maintained,the patient was repositioned to a prone position and standard endoscopic sphincterotomy and endoscopic papillary balloon dilatation procedures were conducted.ERCP was performed successfully and relevant complications did not occur in this patient.We also present a review of the literature published between 1985 and 2014in the Pub Med and EMBASE databases.There were eight published cases during this period,with one each from America,Finland,India,Italy,South Korea and Pakistan,and two from Spain.Our case is the first reported in China.     

Percutaneous biliary intervention for primary sclerosing cholangitis in a patient with situs inversus totalis

Situs inversus totalis is a rare condition that may not cause symptoms and often occurs concomitantly with other congenital anomalies. Special attention must be given to these patients when invasive interventions are required. There are only a few reports concerning percutaneous transhepatic biliary interventions in situs inversus totalis, but technical details were not fully explained. In this report, we attempt to explain the technical details of percutaneous transhepatic cholangiography, percutaneous biliary drainage and percutaneous biliary balloon dilatation in a patient with known primary sclerosing cholangitis and situs inversus totalis. While performing percutaneous biliary interventions in patients with situs inversus totalis, the key point is to use the mirror image of the traditional technique in an imaginary line dissecting the midline of the abdomen.     

Coronary stenting in patients with situs viscerum inversus

Atherosclerotic coronary disease may develop even in patients with complex cardiovascular anomalies who reach adult life. Coronary revascularization (surgical or interventional) may present potential difficulties related to the unusual anatomy. We describe two cases of situs viscerum inversus who underwent cardiac catheterization and angiography as adults because of ingravescent angina. The study identified the cardiac relations and connections, and diagnosed severe coronary disease that was successfully treated with coronary angioplasty and stent implantation. The implications of performing such procedures in patients with similar cardiac anomalies are discussed.     

Living donor liver transplantation for an adult patient with situs inversus totalis

This recipient with situs inversus totalis(SIT) was a 60-year-old female who had hepatitis B-related endstage liver disease.Preoperative donor evaluation showed that the right posterior section satisfied graft volume and was space-fitting in the recipient hepatic fossa when it was rotated 180 degrees.The operation and postoperative course progressed satisfactorily.Three weeks after living donor liver transplantation(LDLT),the graft function was disturbed by compression of bottom-placed right hepatic vein.Th...     

Laparoscopic cholecystectomy for cholecystolithiasis in a case with situs inversus totalis

We report a case of cholecystolithiasis associated with situs inversus totalis (SIT) that had been successfully treated with a laparoscopic cholecystectomy. Although cholecystolithiasis associated with SIT is rare, trained surgeons who perform unusual surgical procedures, even if they have not experienced such a case, would perform laparoscopic cholecystectomy for cholecystolithiasis associated with SIT easily and safely.     

Coronary angioplasty in a patient with situs inversus totalis and a single coronary artery

A patient with congenital situs inversus totalis and a single coronary artery was referred for revascularization because of progressive disabling angina. Exercise thallium scintigraphy had disclosed ischaemia in the anterolateral, posterolateral, and inferior wall of the left ventricle. Percutaneous transluminal coronary angioplasty was performed successfully for stenoses in the right coronary artery.