PMC7452593_01
X-Ray showing bilateral pneumoperitoneum and cardiac point on the right.
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It revealed a bilateral pneumoperitoneum with a cardiac point on the right (Fig. 1).
Thoraco-abdominal CT scan showing (a): liver on the left; spleen and stomach on the right. (b): color reconstruction showing cardiac point on the right.
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The thoraco-abdomino-pelvic scanner was performed and confirmed the diagnosis of gastric perforation on situs inversus totalis: the heart and the arch of the aorta are located on the right, (Fig. 2b), the liver, the gallbladder, and the caeco-appendix were located on the left; the stomach and spleen were on the right (Fig. 2a). The position of the kidneys was also reversed (Fig. 2b).
Intraoperoperative view: (a) gastric perforation; (b): left liver and spleen on the right.
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In the operating room, one liter of bilious peritoneal fluid was aspirated and exploration revealed a perforation of about 0.5 cm in diameter, located on the anterior side of the gastric antrum, (which was in the right) with regular and flexible banks (Fig. 3a).