Blunt Trauma Abdomen with Splenic Injury in a Patient with Situs Inversus: A Case Report

Situs inversus is a rare condition characterized by the mirror-image reversal of the anatomical arrangement of visceral organs. It may be associated with dextrocardia (totalis) or levocardia (incomplete) and is inherited in an autosomal recessive manner. This condition can be linked to congenital heart diseases, ciliary dysfunction, and complications related to anaesthesia. Splenic injury in a patient with situs inversus following blunt abdominal trauma is extremely rare. In cases of high-grade injuries, an emergency splenectomy is typically required, although Tran’s catheter arterial embolization may be attempted in paediatric patients if extravasation is observed. Prophylactic appendectomy may also be considered in such cases. Due to the rarity of this condition, limited information is available regarding postoperative complications, as only a few case reports have been documented. This case report presents a 30-year-old female who was admitted to the emergency department with a history of blunt abdominal trauma, hypotension, and vomiting. A contrast-enhanced CT scan of the abdomen revealed situs inversus totalis with a grade 3 splenic injury, for which an exploratory laparotomy and emergency splenectomy were performed. This is an exceptionally rare case, with fewer than five similar cases reported in the literature to date. Given the potential for postoperative complications related to ciliary dysfunction, anaesthesia, and congenital heart defects, a thorough preoperative evaluation is essential to minimize the risk of such complications.