Duodenal Intussusception in an Adult With Situs Inversus Totalis

TL;DR

A rare case of duodenal intussusception in an adult with situs inversus totalis is reported, highlighting diagnostic challenges due to unusual anatomy.

Contribution

This is the first reported case of duodenal intussusception in an adult with situs inversus totalis.

Findings

Duodenal intussusception is extremely rare in adults and even more so in those with situs inversus totalis.

The patient's condition was diagnosed through clinical and radiological evaluation and required specialist consultation.

This case emphasizes the importance of considering rare anatomical variations in diagnosing abdominal emergencies.

Abstract

Situs inversus totalis (SIT) is a rare congenital abnormality in which there is a mirror image of all thoracic and abdominal organs. Most individuals have no specific health issues. Their unique anatomy can pose challenges when they present to the emergency department with vague symptoms. The condition has been known to be associated with multiple anomalies, including Kartagener syndrome, congenital heart defects, asplenia, gastroschisis, and duodenal atresia, to name a few. However, it is rarely associated with intestinal obstruction. Duodenal intussusception occurs when a portion of the intestine telescopes into another portion of the duodenum and rarely occurs in adults. Here, we present a rare case of a 50-year-old female who presented to the emergency department with complaints of epigastric and left upper quadrant abdominal pain. Following thorough clinical and radiological evaluation, she was discovered to have SIT with evidence of duodenal intussusception. The patient was ultimately transferred to a tertiary center for evaluation by general surgery and gastroenterology and discharged for outpatient follow-up. To the best of our knowledge, this is the first reported case in the literature.

Figures