Abstract
We report a rare case of situs inversus in an elderly patient complicated by ruptured visceral and unruptured abdominal aortic aneurysms. An 87-year-old man was admitted to the emergency service of our hospital after being given a diagnosis of intraperitoneal hematoma based on computed tomography (CT) findings at a nearby medical institution, where he had been admitted with a chief complaint of upper abdominal pain. CT revealed situs inversus of all organs in the chest and abdomen. A ruptured visceral aneurysm at the periphery where the superior pancreaticoduodenal artery joins with the superior mesenteric artery, an infrarenal abdominal aortic aneurysm and intraperitoneal haematoma extending from the upper abdomen to the left intraperitoneum were also detected. The patient was in a state of shock at the time of admission, and underwent emergency visceral aneurysmectomy and vascular graft replacement of the abdominal aorta. The stomach and pancreatic head had been displaced by the hematoma. Visceral aneurysmectomy was followed by bifurcated graft replacement of the abdominal aorta. Although concurrent disseminated intravascular coagulation (DIC), pancreatitis and ileus were caused due to hemorrhagic shock and compression of surrounding organs by the hematoma after the operation, the patient attained remission after conservative treatment.
