Diagnosis,treatment and literature review of situs inversus totalis combined with intestinal neoplasms
Xu Zhifeng1，Li Jianjun2，Zhang Baogui3
1Department of Graduate School,2Department of Clinical College,Jining Medical University,Jining 272067,China；3Department of Castrointestinal Surgery,Affiliated Hospital of Jining Medical University,Jining 272029,China
Abstract：ObjectiveTo investigate the diagnosis and treatment of situs inversus totalis (SIT) combined with intestinal neoplasms.MethodsThe clinical manifestations,diagnosis,and treatment of 1 patient with thoracic-abdominal visceral complete transposition and colorectal cancer was analyzed,and the literatures retrieved from 2007 to 2017 were reviewed.ResultsThe clinical manifestations of the patient were abdominal distension and anemia.The chest and abdomen CT showed：the cardiac apex pointing forward to the right，the thoracic-abdominal tissues and organs completely reversed.Tumor was on the left side and was diagnosed as cecum and ascending colon cancer.Gastroscope showed gastric translocation.The patient underwent radical resection of colon cancer under general anesthesia，postoperative pathology showed colonic adenocar-cinoma.ConclusionsDue to abdominal organ transposition，SIT patients often present opposite symptoms so that misdiagnosis is frequent.It should be as much as possible to complete all relevant tests to confirm the diagnosis and guide operation of the surgery.Diagnosis and treatment should follow the “reverse thinking” principle.In addition，SIT patients combined with digestive tract tumors are not contraindications for laparoscopic and robot surgery，the operation result is also safe and effective.
