A case report of management of gastric perforation in situs inversus totalis in a 45-year-old adult. A case report
| Autor: | Jacques Simpore, Mohamed Stéphane Traoré, Si Simon Traoré, Nabonswindé Lamoussa Marie Ouédraogo, Korotimi Sanogo |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
congenital
hereditary and neonatal diseases and abnormalities medicine.medical_specialty medicine.medical_treatment Perforation (oil well) Situs inversus totalis Physical examination Context (language use) Article Gastric perforation 03 medical and health sciences 0302 clinical medicine Pneumoperitoneum Laparotomy Burkina Faso otorhinolaryngologic diseases medicine Surgical emergency medicine.diagnostic_test business.industry General surgery CT-scan medicine.disease Situs inversus medicine.anatomical_structure 030220 oncology & carcinogenesis Abdomen 030211 gastroenterology & hepatology Surgery business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2020.07.072 |
| Popis: | Highlights • We report the very first case Management of gastric perforation in situs inversus totalis in a 45-year-old adult. • The symptoms of acute peritoneal syndrome have evolved about 48 h. • The thoraco-abdomino-pelvic scan confirmed the diagnosis of gastric perforation and situs inversus totalis. • The patient underwent laparotomy (suture of gasturic perforation, appendicectomy) with uneventful postoperative course. Introduction Situs inversus is a rare congenital malformation often discovered during childhood. It can cause diagnosis errors in adulthood. Its association with gastric perforation is an extremely rare event in the literature. Its diagnosis is made by an adequate morphological assessment. Presentation of case A 45-years-old man, was admitted to the surgical emergency department for generalized acute abdominal pain initially sitting in the right hypochondrium, accompanied by bilious vomiting and a stop in intestinal transit, progressing for 48 h. He had no known surgical history. The clinical examination noted an altered general state (WHO III) and a peritoneal syndrome. A diagnosis of generalized acute peritonitis has been made. An x-ray of the abdomen without preparation revealed a bilateral pneumoperitoneum with a cardiac point on the right. The thoraco-abdomino-pelvic CT scan confirmed the diagnosis. After resuscitation, the patient underwent a laparotomy with gastroraphy and appendectomy. The postoperative follow-ups were without an uneventful, over a 15-month follow-up. Discussion Situs inversus totalis is an uncomon event. Its exact etiology is still unknown. Some authors incriminate an autosomal recessive gene. In our context, its diagnosis is a surprise. Its revelation by gastric perforation is an extremely rare event. Surgical treatment must be performed early. Prognosis is generally better. Conclusion In developing countries the diagnosis of situs inversus is a surprise during a pathology which led the patient to a medical consultation. CT-scan is one of the key paraclinic exams for its diagnosis. |
| Databáze: | OpenAIRE |
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