Chen Jitao, Liu Fei, Tian Jie, Xiang Mingfeng
Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Front Surg. 2022 Oct 14;9:1009949. doi: 10.3389/fsurg.2022.1009949. eCollection 2022.
Situs inversus totalis (SIT) is a rare internal laterality disorder characterized by the mirror arrangement of organs. Multiple gene mutations and maternal environmental factors are thought to cause this variation. It is usually challenging to perform laparoscopic surgery in these cases. Bladder diverticulum is uncommon in children, with an incidence of 1.7%. We report a 14-year-old male patient who was admitted to our department because of lower abdominal pain and frequent urination. A series of examinations confirmed the rare combination of giant bladder diverticulum and SIT. After extensive preoperative discussion, we performed laparoscopic bladder diverticulectomy. The operation was successful. To the best of our knowledge, this is the first report of successful laparoscopic bladder surgery on a case of SIT. This article summarizes the key technical points and the difficulties of performing this kind of operation. In addition, during the process of reviewing the literature, we found that SIT often coexists with some high-risk factors for bladder diverticulum in some rare syndromes. It is helpful to further understand and provide experience in the diagnosis and treatment of the rare combination of bladder diverticulum and SIT in children.
全内脏反位（SIT）是一种罕见的内脏左右不对称疾病，其特征为器官呈镜像排列。多种基因突变和母体环境因素被认为可导致这种变异。在这些病例中进行腹腔镜手术通常具有挑战性。膀胱憩室在儿童中并不常见，发病率为1.7%。我们报告一名14岁男性患者，因下腹痛和尿频入院。一系列检查证实了巨大膀胱憩室与SIT这一罕见组合。经过广泛的术前讨论，我们进行了腹腔镜膀胱憩室切除术。手术成功。据我们所知，这是首例成功对SIT病例进行腹腔镜膀胱手术的报告。本文总结了此类手术的关键技术要点及难点。此外，在文献复习过程中，我们发现SIT在一些罕见综合征中常与膀胱憩室的一些高危因素共存。这有助于进一步了解并为儿童膀胱憩室与SIT这一罕见组合的诊断和治疗提供经验。
