title: Acute gastrointestinal manifestation of situs inversus abdominus.
abstract: Whilst situs inversus is associated with intestinal malrotation and volvulus particularly in infants, this is the first known report of acute intestinal obstruction in an adult patient with a situs anomaly specifically due to a congenital transmesenteric hernia.
  
  
  
  A 54-year-old woman presented with a 12-h history of progressive abdominal pain. Contrast-enhanced computed tomography scan of the abdomen revealed an incidental finding of situs inversus abdominus, ischemic small bowel obstruction and a potential occlusive thrombus of the superior mesenteric artery. At operation, the cause of intestinal obstruction was found to be secondary to herniation of the intestine through a congenital mesenteric defect. The hernia was reduced and a strong pulse was subsequently felt in the distal superior mesenteric artery. The patient required resection of a segment of compromised small bowel, and was later anastomosed at a planned second laparotomy. Her laparostomy was closed using an absorbable BioA mesh.
  
  
  
  A high index of suspicion and low threshold for exploratory surgery should be maintained in patients with major congenital abdominal anomalies presenting with an acute abdomen.
authors: Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, University of Sydney, St Leonards, Sydney, NSW, 2065, Australia. kai.matthew.brown@gmail.com.
authors: K M
authors: KM
authors: Brown
authors: Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, University of Sydney, St Leonards, Sydney, NSW, 2065, Australia.
authors: J S
authors: JS
authors: Gundara
authors: Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, University of Sydney, St Leonards, Sydney, NSW, 2065, Australia.
authors: A
authors: A
authors: Mittal
mesh_terms: D000005:Abdomen; D000006:Abdomen, Acute; D015746:Abdominal Pain / Q000209:etiology; D003287:Contrast Media; D005260:Female; D006547:Hernia / Q000150:complications / Q000151:congenital*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery; D007421:Intestine, Small; D007422:Intestines; D007511:Ischemia; D007813:Laparotomy; D008643:Mesentery / Q000002:abnormalities; D008875:Middle Aged; D012857:Situs Inversus / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
keywords: Abdominus; Internal hernia; Inversus; Situs