Peritonitis by Gastric Ulcer Perforation Associated with Mesenteric Infarction on Situs Inversus: Case Report

Complete situs inversus is a rare embryological anomaly characterised by complete inversion of the positions of thoracic and abdominal organs;

Acute mesenteric infarction and gastric ulcer perforation are surgical emergencies with serious consequences. The association of these two pathologies remains one of the rare entities whose mechanism remains subject to multiple hypotheses.

The present article reports the case of 78 year old patient who was admitted with peritonitis due to hollow organ perforation.

The abdominal scan showed a large pneumoperitoneum associated with signs of digestive distress with inversion of the position of the abdominal organs (liver on the left, spleen on the right).

Surgical exploration revealed the presence of a 1.5 cm pyloric perforation associated with necrosis of the distal small intestine and coecum with inversion of the position of the abdominal organs (liver and gall bladder on the left, spleen and stomach on the right and coecum and appendix located at the level of the left iliac fossa) achieving a complete situs inversus