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Start Over Author "Simporé, Jacques" Publisher elsevier b.v.
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17. A case report of management of gastric perforation in situs inversus totalis in a 45-year-old adult. A case report.

Author

Ouédraogo, Nabonswindé Lamoussa Marie, Sanogo, Korotimi, Traoré, Mohamed Stéphane, Simporé, Jacques, and Traoré, Si Simon

Abstract

• 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. 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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Published
2020
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