Situs inversus abdominalis and duodenal atresia: A case report and review of the literature

Abstract

Fewer than 20 patients have been reported in the literature that were born with situs inversus and duodenal atresia. We present a patient with this condition. A newborn baby presented shortly after birth with persistent bilious vomiting. AXR showed a right sided stomach bubble and a second bubble on the left –typical for duodenal atresia but with mirror image configuration. Laparotomy confirmed the diagnosis of situs inversus abdominis which was also demonstrated by contrast studies and ultrasound. Duodeno-duodenostomy was performed and patient discharged day 8 post-op. Situs Inversus is associated with other congenital malformations including splenic malformations, left-sided liver and cardiac abnormalities, however rarely is it associated with duodenal atresia. [1] Duodenal obstruction in the presence of situs inversus has been described which include obstruction due to a web, stenosis, pre-duodenal portal vein and complete atresia. [2] The patient presented in this paper had a duodenal web in the second part of the duodenum. Prior to undertaking surgery it is important to establish the presence of associated gastrointestinal and cardiac abnormalities.