A case of situs inversus totalis with sigmoid volvulus: a case report of a rare coexistence.

Abstract

Introduction: Situs inversus totalis is an uncommon congenital disease characterized by the full transposition of thoracic and abdominal organs. Sigmoid volvulus, an unusual but potentially catastrophic cause of major bowel obstruction, is rarely associated with Situs inversus.

Case presentation: A 76-year-old male presented with abdominal pain and obstipation for 5 days. Clinical examination and imaging revealed signs of bowel obstruction and dextrocardia. Computed tomography (CT) scan abdomen confirmed sigmoid volvulus and situs inversus totalis. Emergency laparotomy revealed a 360-degree twisted, dilated sigmoid colon. Manual detorsion and excision of fibrous bands were performed. The patient recovered uneventfully.

Clinical discussion: While sigmoid volvulus is a known surgical emergency, its diagnosis in situs inversus patients can be challenging due to reversed anatomical landmarks. Imaging plays a critical role in both diagnosis and surgical planning.

Conclusion: Awareness of reversed anatomy in situs inversus is crucial for prompt diagnosis and successful surgical management acute abdominal conditions like volvulus.