Situs Inversus Totalis With Symptomatic Cholelithiasis: A Rare Clinical Presentation

GASOC International Conference 2025
ABSTRACT FIRST PRESENTED: 24.10.2025

doi: 10.52648/GASOC.1006_329

Situs Inversus Totalis With Symptomatic Cholelithiasis: A Rare Clinical Presentation

Prajwala Yogi , Kishor Kumar Deo, Pravakar Dawadi, Jiya Acharya, Suraksha Thapa, Dikshya Maharjan, Ghanashyam Thapa, Simran Bista
National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal; Department of Surgery, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal; Nepalese Army Institute of Health Sciences, Kathmandu, Nepal; Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal

Introduction: Situs inversus totalis (SIT) is a rare congenital anomaly with a mirror image of organs. Laparoscopic cholecystectomy (LC) in these patients is often challenging for surgeons.

Case description: A 39-year-old female with SIT had complaints of symptomatic cholelithiasis. The site of pain was unusual in the epigastric subcostal region. Although the imaging report confirmed SIT, the abdominal ultrasound reported a significant finding showing cholelithiasis. With a strong clinical suspicion as the basis, laparoscopic cholecystectomy was performed.

Discussion: The presence of atypical pain reported in a few cases of SIT and conflicting imaging details presents a diagnostic challenge. This case highlights the importance of clinical judgment over conflicting radiographic findings. The mirror image anatomy demands modifications to tackle ergonomic hurdles for the surgical team. LC is a safe procedure with additional modifications, supported by existing evidence.

Main learning points: In the presence of conflicting imaging findings, clinical evaluation should be prioritised. Even in patients with SIT, laparoscopic cholecystectomy is safe with necessary pre-operative planning and technical modifications.

Keywords: dextrocardia; gallstones; laparoscopic cholecystectomy; situs inversus totalis.

No Entries Found

Other abstracts

Dermatological Emergency In Pregnancy – A Case Of Generalised Pustular Psoriasis In An Obstetric Setting

Baseline Characteristics And 14-day Outcomes Of Patients Admitted With Sepsis To The Intensive Care Unit: A Prospective, Single Arm Cohort Study At Women And Newborn Hospital, Uth, Lusaka, Zambia.

Global Partnership With India – 20 Years Of Opportunities, Challenges And Successes!

Assessing Sexual Reproductive Health Needs Of Rural Communities In Northern Uganda

Orthopaedic Management For A Delayed Presentation Of A Traumatic ‘Floating Knee’ Injury In Rural Uganda Due To Inequality: A Case Report

Making Scientific Conferences Effective Learning Platforms For Global Surgery Trainees: A Review Of Literature And Experience From University Of Global Health Equity, Rwanda

“The Fy1 Toolkit”: A Two-year Near-peer Teaching Programme And Quality Improvement Project.

Knotbox: A Potential Low-cost Knot-tying Simulation Model For Lmic Medical Students Prototyped During K.n.o.t Campaign.

A Reflection Of The Challenges And Lessons Learned From My Experience Of Conducting Low-fidelity Simulation Training For Anaesthesia Residents At A University Hospital In Ethiopia

Perimortem Caesarean Section: An Experience Of A Rarely Performed But Life-saving Procedure In A Low-resource Setting

Review Of Colorectal Biopsy Turnaround Times Over Six Months At Warwick Hospital

Structured Basic Laparoscopic Surgical Skill Using A Low Cost Simulation Box For Medical Students In A Lower-resource Setting.

Simulation Education (simed) Nepal Survey: Medical Student Perspectives On Simulation-based Surgical Education In Lmics

Circumcision During The Covid-19 Era In A Northern Ireland Health And Social Care Trust (hsct): Are We Meeting National Waiting Time (wt) Targets?

Perception Of Objective Structured Clinical Examination (osce) By The 400 Level Medical Students: Reflecting On The Impact Of The Surgical Residents

The Availability Of Equipment And Supplies For Trauma And Orthopaedic Care In Sub-saharan Africa: What Are The Challenges Faced And How Can These Be Overcome?

Surgical Management Of Abdominal Wall Defect In Prune Belly Syndrome – A Systematic Scoping Review Of The Literature

Inguinal Mesh Hernia Repair (MHR) In Sierra Leone (SL): Complication Rates Are Comparable To High Income Settings

Inguinal Mesh Hernia Repair (MHR) In Sierra Leone (SL): Early Results Suggest Headroom For Antibiotic Stewardship

Burn Management In Resource Limited Setting: Lessons From Zambia

“Is The Use Of Single-use Surgical Drill Bits In Orthopaedics Compliant With Nhs Sustainability Goals And Justified By Evidence-based Infection Control Guidelines?”

A Cross-country Audit Of Antimicrobial Prescribing In Emergency General Surgery: A Mixed-methods Analysis From The UK And Nepal

AI-driven Early Detection Warning System For Obstetric Emergencies In LMICs

Diagnostic Conundrum In Prostatic Urethral Cancer: Is It Primary Or Secondary?

Immunosuppression Masking A Urological Emergency: A Case Report Of Bilateral Infected Obstructed Kidneys

First On Scene: A Scoping Review Of Community-based Prehospital Trauma Response In Uganda

Implementing Early Detection Of Postoperative Deterioration With Enhanced Monitoring Using Sensors In Variably Resourced Contexts

Cost-effective Laparoscopic Simulation Models In Surgical Training Programmes For Low- And Middle-income Countries: A Comprehensive Literature Review

Hybrid Conferences As A Catalyst For Bridging LMIC And HIC Medical Education: Connecting Kings To Karnali

Current Trends In Burden And Management Of Pediatric Osteomyelitis: A Systematic Review Of The Last Decade

Advancing Gender Equity In Surgery : Insights From Nepalese Medical Students Through Women In Surgery Initiative And International Mentorship Webinar

Igniting The Spark Early : A Pilot Basic Laparoscopic Skills Course For High School Students In Nepal

Situs Inversus Totalis With Symptomatic Cholelithiasis: A Rare Clinical Presentation

What Is The Effectiveness Of Non-surgical Interventions In The Management Of Ectopic Pregnancies In LMICs?

The Weight Of Words: Documenting Post-operative Mobilisation And Weight Bearing Status For Orthopaedic Patients

An Audit Of Global Vascular Guidelines Implementation At Two Large Teaching Hospitals In Differing Healthcare Settings

Global Surgery: Ethical And Legal Challenges Facing Surgeons

Re-audit Of Antibiotic Use In Acute Diverticulitis: Comparing Local Practice With Nice Guidelines

A Closed-loop Audit On Monitoring Visual Infusion Phlebitis Score And Timely Removal Of Peripheral Venous Cannulas In Patients Within Trauma & Orthopaedics Wards

A Rare Case Of Treatment-resistant Complex Regional Pain Syndrome

Audit Of Letz Procedure

Voiceless Births: Regulation, Invisibilities, And Rights In Brazil

To Assess Sedation-related Adverse Events And Associated Factors Among Patients Undergoing Gastrointestinal Endoscopy At Muhimbili National Hospital, Dar Es Salaam, Tanzania

The Surgeons Working In Africa Together For Safer Surgery (SWIFTSS) Hernia Model: Putting Ultra-low-cost Hernia Simulation Into Everybody’s Hands

Strengthening Surgical Foundations: The K.N.O.T. (Keep No Operation Tangled) Campaign For Surgical Skill-building Among Medical Students In The Low-resource Settings

Socioeconomic Disparities Effect On Ostomates In Colorectal Cancer

Awareness And Contraceptive Uptake Among Women With Sickle Cell Disease In A Nigerian Tertiary Hospital

Primary Bladder Lymphoma In An Elderly Asian Female: A Rare Urological Enigma

Bridging The Skills Gap: A Call For Greater Exposure To Ultrasound-guided Peripheral Nerve Blocks Among Anaesthesia Trainees In Kenya And Zambia

Strengthening Open-access Surgical Education: A Curriculum Review Of Surghub Modules

Re-audit Of Antibiotic Use In Acute Diverticulitis: Comparing Local Practice With Nice Guidelines

Peer Teaching Across Borders: A Reverse-teaching Pilot Between Low-and-middle Income Countries (LMIC) And High-income Countries (HIC) Trainees

Management Of Paediatric Testicular Torsion In Low- And Middle-income Countries: Results Of A Round 1 Delphi Study

Introduction Of Major Gynaecology Enhanced Recovery Programme To Reduce Delays To Discharge Due To Pain For Patients Undergoing Hysterectomy Procedures

Postoperative Pain Management In Urological Surgeries

Improving Operative Note Quality Through Standardized Documentation A Closed-loop Audit In The Plastic Surgery Unit (Atbara-Sudan)

Impact Of Global Health Equity Pathway On Anesthesiology Training

Global Surgery In Medical School: A Cross-sectional Study On Awareness, Exposure, And Interest In Global Surgery Among Medical Students In Nepal