Incidental finding of complete situs inversus in a polytraumatized adult.

BACKGROUND

Situs inversus is a rare abnormality typically posing a diagnostic dilemma during routine evaluation of acute abdominal emergencies such as in acute appendicitis and cholecystitis. It is rare to detect such in the setting of trauma.

OBJECTIVE

To report an incidental finding of complete situs inversus in a poly-traumatized adult.

METHODS

The clinical records of the patient including preoperative evaluation, intra-operative findings and postoperative care were reviewed.

RESULT: A 53 year old man presented with difficulty breathing, left sided chest pain, generalized abdominal pain and distension 18 hours after a vehicular road traffic accident. Examination revealed features of left sided haemothorax, absent heart sounds, generalized peritonitis and limb injuries. Plain chest radiograph confirmed left haemothorax with dextrocardia. He had a left closed thoracostomy tube drainage and exploratory laparotomy which revealed complete situs inversus of intra-abdominal organs alongside a jejunal perforation which was repaired. Postoperative recovery was uneventful.

CONCLUSION

Complete situs inversus is uncommon and may not be anticipated in evaluation of trauma patients. Preoperative clinical and radiological evaluation may however be helpful in making a pre-operative diagnosis and further management.