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<p>Situs inversus totalis (SIT) is a rare congenital anomaly in which the thoracic and abdominal organs are arranged in a mirror-image position. The coexistence of cholelithiasis and ruptured liver abscess in SIT is exceptionally rare. A 26-year-old male with SIT presented with left upper abdominal pain and fever. Imaging revealed cholelithiasis and a ruptured liver abscess. He was initially managed with ultrasound-guided pigtail drainage. Diagnostic laparoscopy showed severe adhesions and a Parkland Grade IV gallbladder, for which cholecystectomy was deferred. Interval elective laparoscopic cholecystectomy was performed six weeks later once inflammation subsided. Mirror-image port configuration and ambidextrous handling of instruments allowed safe dissection. The patient recovered uneventfully. Staged laparoscopic management is feasible and safe in SIT with severe inflammation, highlighting the importance of preoperative planning and surgical adaptability.</p>

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Laparoscopic Cholecystectomy in Situs Inversus Totalis with Concurrent Liver Abscess: A Rare Case and Literature Review

  • 期刊论文

  • 发表日期：

    2026年2月11日

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  • Sanjay Singh,
  • Aditya Sagar,
  • Tripti Agarwal,
  • Naincy Priyadarshi,
  • Ajay Sahani

摘要

Situs inversus totalis (SIT) is a rare congenital anomaly in which the thoracic and abdominal organs are arranged in a mirror-image position. The coexistence of cholelithiasis and ruptured liver abscess in SIT is exceptionally rare. A 26-year-old male with SIT presented with left upper abdominal pain and fever. Imaging revealed cholelithiasis and a ruptured liver abscess. He was initially managed with ultrasound-guided pigtail drainage. Diagnostic laparoscopy showed severe adhesions and a Parkland Grade IV gallbladder, for which cholecystectomy was deferred. Interval elective laparoscopic cholecystectomy was performed six weeks later once inflammation subsided. Mirror-image port configuration and ambidextrous handling of instruments allowed safe dissection. The patient recovered uneventfully. Staged laparoscopic management is feasible and safe in SIT with severe inflammation, highlighting the importance of preoperative planning and surgical adaptability.