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全内脏转位合并乙状结肠扭转1例:罕见并存情况的病例报告

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

作者信息

Anmol Singh Shrestha, Shrestha Puspharaj, Nabin Pahari, Chandresh Kumar Singh, Sahas Chhetri, Mukesh Pahari

机构信息

Department of Intensive Care, Devdaha Medical College, Rupandehi, Nepal.

Department of Emergency Medicine, Devdaha Medical College, Rupandehi, Nepal.

出版信息

Ann Med Surg (Lond). 2025 Jul 25;87(9):6193-6196. doi: 10.1097/MS9.0000000000003651. eCollection 2025 Sep.

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.

摘要

引言

全内脏转位是一种罕见的先天性疾病,其特征为胸腹部器官完全转位。乙状结肠扭转是主要肠梗阻的一种不常见但可能具有灾难性的病因,很少与全内脏转位相关。

病例报告

一名76岁男性因腹痛和便秘5天就诊。临床检查和影像学检查显示肠梗阻和右位心体征。腹部计算机断层扫描(CT)证实为乙状结肠扭转和全内脏转位。急诊剖腹手术发现乙状结肠扭转360度且扩张。进行了手法复位和纤维带切除。患者顺利康复。

临床讨论

虽然乙状结肠扭转是一种已知的外科急症,但由于解剖标志相反,在全内脏转位患者中诊断可能具有挑战性。影像学在诊断和手术规划中都起着关键作用。

结论

认识到全内脏转位中的解剖结构反转对于快速诊断和成功手术治疗像扭转这样的急性腹部疾病至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae45/12401335/ec8d19f8caa1/ms9-87-6193-g001.jpg

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