PMC3015421_01
Preoperative ECG revealing right axis deviation, positive QRS complex in lead aVR, negative QRS in leads I and aVL, suggestive of dextrocardia.
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F1
A preoperative electrocardiogram (ECG) (Figure 1) showed a right axis deviation, positive QRS complex in aVR, and a negative QRS in leads I and aVL, consistent with dextrocardia.
Intraoperative laparoscopic photograph of the gallbladder following the release of omental adhesions. Situs inversus is apparent, as is the location of the gallbladder in the left upper quadrant
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F2
The gallbladder was then visualized and dense omental adhesions were released (Figure 2).
PMC3015421_02
Intraoperative laparoscopic photographs taken upon initial attempt to visualize the gallbladder. Note the normally situated liver and falciform ligament and the absence of the gallbladder in its usual location.
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F3
Further exploration revealed the gall-bladder to lie to the left of the round ligament (Figures 3,4,5).