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. 2015:10:216-8.
doi: 10.1016/j.ijscr.2015.04.007. Epub 2015 Apr 8.

Situs inversus totalis and abdominal aortic aneurysm: Surgical repair of an extremely uncommon association

Claudia Riera Hernández  1 , P Pérez Ramírez  2 , C Esteban Gracia  3 , M A Jiménez Olivera  4 , S Llagostera Pujol  5
Affiliations

Situs inversus totalis and abdominal aortic aneurysm: Surgical repair of an extremely uncommon association

Claudia Riera Hernández et al. Int J Surg Case Rep. 2015.

Abstract

Introduction: Situs inversus totalis (SIT) is an uncommon congenital syndrome, which refers to a reversal mirror-image of the normal thoracoabdominal organs position. The coexistence of SIT and abdominal aortic aneurysm has been seldom previously reported.

Presentation of the case: We report a case of a 69-year-old man with SIT and infrarenal abdominal aortic aneurysm (AAA) that underwent open repair with a straight graft through a minilaparatomy without evisceration.

Discussion: There is no consensus on which should be the optimum approach in cases of open surgical repair of AAA due to the limited number of cases described. The fact of intestinal scrolling to the left abdomen, unlike usual, is due to the anatomical arrangement of the root of the mesentery which is directed obliquely from duodenojejunal on the left side of the vertebra L2 to the ileocecal junction and right sacroiliac joint.

Conclusion: A minilaparotomy without evisceration and with intestinal scrolling to left hemiabdomen, can be very useful and beneficial on those cases of congenital anatomical abnormalities that may add difficulty during the surgical procedure.

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Figures

Fig. 1
Fig. 1
A computed tomography (CT) scan shows SIT and AAA. The inferior vena cava is on the left side.
Fig. 2
Fig. 2
The photograph shows the inferior mesenteric artery heading right.
Fig. 3
Fig. 3
A surgical photograph shows a mini median laparotomy without evisceration and the graft interposed before being wrapped with the aneurysm sac.
Fig. 4
Fig. 4
A photograph of the surgical incision length.
See this image and copyright information in PMC

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