Title: Case Report of a Patient with Situs Inversus Totalis with Ciliary Dysfunction for Laparoscopic Cholecystectomy: Considerations for Safe Peri-Operative Anaesthetic Management
Authors: Ipsita Chattopadhyay, Srabani Basu
DOI: https://dx.doi.org/10.18535/jmscr/v5i12.152
Abstract
Patients with rare genetic disorders are associated with diverse congenital anomalies and present special challenges to the anaesthesiologist. We report the successful management of a 20 year old female with situs inversus totalis and suspected kartagener syndrome posted for laparoscopic cholecystectomy surgery.
Cases of situs inversus with or without ciliary dysfunctions are known to have several structural and functional abnormalities especially those as cardiac, spine and airway malformations, presenting a challenge to an inadequately equipped and mis-informed anaesthesiologist. This calls for an individualisation of the peri-operative concerns of such patients based on associated anomalies along with appropriate monitoring.
In this report we highlight the evaluations done and precautions taken during the management of such a patient who underwent successful management at our centre. It is recommended that such patients with multiple congenital anomalies be given a thorough and cautious assessment for a safe intra-operative and postoperative course.
Keywords: Peri-operative management. Kartagener syndrome. Situs inversus totalis
Key Messages: Cases of situs inversus totalis with ciliary dysfunction reveal a very unique set of problems due to multiple functional and structural abnormalities that might coexist with it. A review of nomenclatures of the abnormalities of left-right asymmetry with specific organ system malformations reported in these patients is presented here and their implications for anaesthetic care are discussed.
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