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Case Report 


Laparoscopic cholecystectomy in patient with situs inversus totals: Diagnostic and treatment pitfalls

Roberto Marcellus de Barros Sena, Marcelo Barros Weiss, Ana Paula Teixeira de Abreu, Luisa Pires Costa, Rodrigo Pereira Peixoto,Camila Couto Gomes, Ana Paula Fernandes Braga, Felipe Couto Gomes, Carlos Augusto Gomes.

Abstract
Situs inversus totalis, a rare congenital recessive autosomal malformation described in humans by Fabricius, in 1600, is characterised by the viscera’s transposition. It presents the incidence of approximately one case to each 10.000-20.000 newborns. The main etiology is still unknown and when the abdominal and thoracic visceral commitment is associated, including dextrocardia, it is described as situs inverses totalis. We report the case of a female patient, 16-years-old, who came to the Digestive Surgical Department, in hospital Therezinha de Jesus, Juiz de Fora – MG – Brazil, complaining of pain in the left hypochondrium, associated to nauseas and vomiting. The patient mentioned that she had been suffering for 4 months and that the pain worsened in the previous 2 days. At the general clinical examination, she presented a cardiac focus ausculta in the right hemithorax, however, without abnormalities. The abdomen was flat, without surgical scars, ventral or inguinal hernias. There was hyperthermia, pain in the deep palpation on the left hypochondrium, associated guarding and rebound tenderness. The patient told that she had a previous diagnosis of situs inversus totalis. The aim of this case report is to describe a patient with cholecystitis associated with situs inversus totalis, who was previously aware of her congenital abnormality. Moreover, we review some aspects for the correct diagnosis, and propose recommendations for a safe laparoscopic cholecystectomy.

Key words: Cholecystectomy, cholelytiase, laparoscopy, situs inversus


 
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How to Cite this Article
Pubmed Style

Sena RMdB, Weiss MB, Abreu APTd, Costa LP, Peixoto RP, Gomes CC, Braga APF, Gomes FC, Gomes CA. Laparoscopic cholecystectomy in patient with situs inversus totals: Diagnostic and treatment pitfalls. Arch Clin Exp Surg. 2016; 5(2): 124-127. doi:10.5455/aces.20140719055828


Web Style

Sena RMdB, Weiss MB, Abreu APTd, Costa LP, Peixoto RP, Gomes CC, Braga APF, Gomes FC, Gomes CA. Laparoscopic cholecystectomy in patient with situs inversus totals: Diagnostic and treatment pitfalls. http://www.ejmaces.com/?mno=161339 [Access: May 26, 2018]. doi:10.5455/aces.20140719055828


AMA (American Medical Association) Style

Sena RMdB, Weiss MB, Abreu APTd, Costa LP, Peixoto RP, Gomes CC, Braga APF, Gomes FC, Gomes CA. Laparoscopic cholecystectomy in patient with situs inversus totals: Diagnostic and treatment pitfalls. Arch Clin Exp Surg. 2016; 5(2): 124-127. doi:10.5455/aces.20140719055828



Vancouver/ICMJE Style

Sena RMdB, Weiss MB, Abreu APTd, Costa LP, Peixoto RP, Gomes CC, Braga APF, Gomes FC, Gomes CA. Laparoscopic cholecystectomy in patient with situs inversus totals: Diagnostic and treatment pitfalls. Arch Clin Exp Surg. (2016), [cited May 26, 2018]; 5(2): 124-127. doi:10.5455/aces.20140719055828



Harvard Style

Sena, R. M. d. B., Weiss, M. B., Abreu, A. P. T. d., Costa, L. P., Peixoto, R. P., Gomes, C. C., Braga, A. P. F., Gomes, F. C. & Gomes, C. A. (2016) Laparoscopic cholecystectomy in patient with situs inversus totals: Diagnostic and treatment pitfalls. Arch Clin Exp Surg, 5 (2), 124-127. doi:10.5455/aces.20140719055828



Turabian Style

Sena, Roberto Marcellus de Barros, Marcelo Barros Weiss, Ana Paula Teixeira de Abreu, Luisa Pires Costa, Rodrigo Pereira Peixoto, Camila Couto Gomes, Ana Paula Fernandes Braga, Felipe Couto Gomes, and Carlos Augusto Gomes. 2016. Laparoscopic cholecystectomy in patient with situs inversus totals: Diagnostic and treatment pitfalls. Archives of Clinical and Experimental Surgery (ACES), 5 (2), 124-127. doi:10.5455/aces.20140719055828



Chicago Style

Sena, Roberto Marcellus de Barros, Marcelo Barros Weiss, Ana Paula Teixeira de Abreu, Luisa Pires Costa, Rodrigo Pereira Peixoto, Camila Couto Gomes, Ana Paula Fernandes Braga, Felipe Couto Gomes, and Carlos Augusto Gomes. "Laparoscopic cholecystectomy in patient with situs inversus totals: Diagnostic and treatment pitfalls." Archives of Clinical and Experimental Surgery (ACES) 5 (2016), 124-127. doi:10.5455/aces.20140719055828



MLA (The Modern Language Association) Style

Sena, Roberto Marcellus de Barros, Marcelo Barros Weiss, Ana Paula Teixeira de Abreu, Luisa Pires Costa, Rodrigo Pereira Peixoto, Camila Couto Gomes, Ana Paula Fernandes Braga, Felipe Couto Gomes, and Carlos Augusto Gomes. "Laparoscopic cholecystectomy in patient with situs inversus totals: Diagnostic and treatment pitfalls." Archives of Clinical and Experimental Surgery (ACES) 5.2 (2016), 124-127. Print. doi:10.5455/aces.20140719055828



APA (American Psychological Association) Style

Sena, R. M. d. B., Weiss, M. B., Abreu, A. P. T. d., Costa, L. P., Peixoto, R. P., Gomes, C. C., Braga, A. P. F., Gomes, F. C. & Gomes, C. A. (2016) Laparoscopic cholecystectomy in patient with situs inversus totals: Diagnostic and treatment pitfalls. Archives of Clinical and Experimental Surgery (ACES), 5 (2), 124-127. doi:10.5455/aces.20140719055828





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