Abstract

Situs inversus is an autosomal recessive anomaly characterized by transposition of abdominal viscera, and when associated with a right sided heart (Dextrocardia) is referred to as situs inversus totalis. Mathew Baillie was first to described situs inversus totalis in early twentieth century. Complete situs inversus is a rare syndrome, of autosomal recessive inheritance, with an estimated prevalence of around 1/10 000 births. The frequency of cholelithiasis in patients with situs inversus is similar to that in the general population. However, the condition may present diagnostic difficulty. In the published literature, there have been only 40 reports of open cholecystectomy in pre-laparoscopic era and 21 reports of laparoscopic cholecystectomy in situs inversus patients till date. We present the case of a 21 year old male with situs inversus totalis with symptomatic cholelithiasis which was successfully treated with Laparoscopic cholecystectomy. The mirror image anatomy poses difficulty in orientation during laparoscopic cholecystectomy in patients with situs inversus. The surgeon needs to reorient visual images and surgical steps in an anatomical field that has undergone 180® rotation. We conclude that though laparoscopic cholecystectomy in patients with situs inversus is technically more demanding although an experienced laparoscopic surgeon can perform it safely.

Keywords: Situs Inversus ; Cholelithiasis ; Laparoscopic Cholecystectomy.