Ali EZER, Nezih AKKAPULU, Alper PARLAKGÜMÜŞ

Penetrating Thoracoabdominal Trauma in a Patient with Situs Inversus Totalis: A Case Report and Review of the Literature

Introduction: Situs inversus totalis is a rare congenital anomaly in which the thoracic and abdominal organs are located inmirror positions compared to their usual anatomical locations. Trauma in a patient with situs inversus totalis is unexpected indaily emergency and surgical settings.Case Report: We present the case of a 36-year-old male patient who had multiple stab wounds to the thoracoabdominalregion, and situs inversus totalis was coincidentally diagnosed. We detected diaphragmatic laceration with gastric perforationand repaired it primarily.Conclusion: This anatomic anomaly could be challenging for acute care surgeons during surgical management if it is notpreoperatively recognized. We also reviewed and presented identifying characteristics of trauma patients with situs inversustotalis in the literature.

PDF

___

1. Deng H, Xia H, Deng S. Genetic basis of human left-right asymmetry disorders. Expert Rev Mol Med 2015; 16: e19. [CrossRef ]
2. Blegen HM. Surgery in Situs Inversus. Ann Surg 1949; 129: 244-59. [CrossRef]
3. Rhee PM, Moore EE, Joseph B, Tang A, Pandit V, Vercruysse G. Gunshot wounds: A review of ballistics, bullets, weapons, and myths. J Trauma Acute Care Surg 2016; 80: 853-67. [CrossRef ]
4. Petrowsky H, Raeder S, Zuercher L, Platz A, Simmen HP, Puhan MA, et al. A quarter century experience in liver trauma: a plea for early computed tomography and conservative management for all hemodynamically stable patients. World J Surg 2012; 36: 247-54. [CrossRef ]
5. Biffl WL, Leppaniemi A. Management guidelines for penetrating abdominal trauma. World J Surg 2015; 39:1373-80. [CrossRef ]
6. Vento AE, Heikkila L, Perhoniemi V, Salo JA. Delayed intrathoracic herniation of the stomach with pleural empyema due to diaphragmatic stab wound. Scand J Thorac Cardiovasc Surg 1996; 30: 45-8. [CrossRef ]
7. Wilson E, Metcalfe D, Sugand K, Sujenthiran A, Jaiganesh T. Delayed recognition of diaphragmatic injury caused by penetrating thoracoabdominal trauma. Int J Surg Case Rep 2012; 3: 544-7. [CrossRef ]
8. Gedda L, Sciacca A, Brenci G, Villatico S, Bonanni G, Gueli N, et al. Situs viscerum specularis in monozygotic twins. Acta Genet Med Gemellol (Roma) 1984; 33: 81-5. [CrossRef ]
9. Turk F, Yuncu G, Ozturk G, Ekinci Y, Semerkant T. Total situs inversus found coincidentally following a firearm injury. J Forensic Sci 2013; 58: 232-3. [CrossRef ]
10. Kamath B, Chatterjee AS, Chandorkar I. Splenic Injury in Situs Inversus Totalis - A Surgical Challenge. J Clin Diagn Res 2015; 9: PD01-2. [CrossRef]
11. Ribas-Filho JM M-JI, Ribas FM, Czeczko LEA, Kuradomi IY, Badia EA: Firearm injury patients with situs inversus totalis - case report. ABCD Arq Bras Cir Dig 2011; 24: 249-50. [CrossRef ]
12. Srivastva V, Kumar P, Dosar S. A case of splenic rupture in patient of situs inversus. Indian J Surg 2010, 72: 326-7. [CrossRef ]
13. Uludag M, Citgez B, Ozkurt H. Delayed small bowel perforation due to blunt abdominal trauma and periappendicitis in a patient with situs inversus totalis: a report of a case. Acta Chir Belg 2009; 109: 234-7. [CrossRef]
14. Bilello JF, Birnbaum PL, Venugopal C, Fong LL. Endovascular repair of blunt aortic injury in a patient with situs inversus and dextrocardia. J Vasc Surg 2011; 54: 857-9. [CrossRef ]
15. Christmas AB, Knick BN, Motameni AT, Miles WS. Identification of traumatic, right-sided diaphragm rupture in a patient with newly diagnosed situs inversus. Surgery 2010; 148: 607-8. [CrossRef ]
16. Olasehinde O, Owojuyigbe AM, Adisa AO, Awowole IO. Incidental finding of complete situs inversus in a polytraumatized adult. Afr J Med Med Sci 2014; 43: 183-6.
17. Ahmad R, Suhail M, Nafae A, Khan Q, Salam P, Bashir S, et al. Isolated Blunt Traumatic Diaphragmatic Rupture in a Case of Situs Inversus. Surgical Sciences 2015; 6: 133-7. [CrossRef ]
18. Khandelwal R, Chaudhary R, Kumar L, Singh M, Usurumarthi P, Singh S, et al. Splenic rupture in a patient with situs inversus. JRSM Short Rep 2012; 3: 61. [CrossRef ]
19. Magishi K, Izumi Y, Ishikawa N, Kimura F. Stanford type A acute aortic dissection caused by blunt trauma in a patient with situs inversus. Ann Thorac Surg 2006; 81: 2294-6. [CrossRef ]
20. Kulick DM, Park SJ, Harrison BS, Shumway SJ. Traumatic aortic and diaphragmatic rupture in a patient with dextrocardia and situs inversus: case report. J Trauma 1998; 45: 397-9. [CrossRef ]
21. Engelberg M, Jedeikin RJ, Zager M, Hoffman S, Reiss R. Traumatic rupture of a left-sided liver and postoperative acute respiratory failure in a patient with Kartagener's syndrome. J Trauma 1978; 18: 545-7. [CrossRef]
22. Ahadi R, Shamshirband H. Two Case Reports of Situs Inversus Totalis. Anat Sci J 2013; 10: 111- 6.
23. Winer-Muram HT. Adult presentation of heterotaxic syndromes and related complexes. J Thorac Imaging 1995; 10: 43-57. [CrossRef ]
24. Bajwa SJ, Kulshrestha A, Kaur J, Gupta S, Singh A, Parmar SS. The challenging aspects and successful anaesthetic management in a case of situs inversus totalis. Indian J Anaesth 2012; 56: 295-7. [CrossRef ]