Situs inversus totalis with ileal neuroendocrine tumour: A diagnostic and surgical challenge
DOI:
https://doi.org/10.63341/ijmmr/2.2025.34Keywords:
intestinal obstruction, adenocarcinoma, malrotation, abdominal tuberculosis, small intestine, emergency surgeryAbstract
Small intestine neuroendocrine tumours are becoming increasingly widespread, despite being a relatively
rare condition. While abdominal computed tomography scans during routine check-up often detect small intestine
neuroendocrine tumours, many cases are still diagnosed unexpectedly during emergency surgery. This subject is relevant
because two rare conditions, situs inversus totalis and intestinal malrotation, can also affect the abdominal region thus
misleading the diagnosis. The purpose of this study was to highlight the case of an acute onset of small bowel obstruction
caused by neuroendocrine tumour with concomitant presence of situs inversus totalis. Situs inversus totalis usually stays
asymptomatic, being discovered by chance during imaging, or manifests itself early in neonatal period with obstructive
features or in old age as acute intestinal obstruction. However, this case is unique as the coexistence of situs inversus totalis and small intestine neuroendocrine tumours causing acute intestinal obstruction has not been previously reported in
medical literature. The patient was diagnosed with a case of situs inversus totalis; when evaluated for cause of recurrent
intestinal obstruction, the patient developed a fresh episode of acute intestinal obstruction while check-up was still
ongoing and had to be taken up for emergency exploratory laparotomy. Patient underwent segmental small bowel
resection and stapled side-to-side anastomosis. The real cause for recurrent obstructions was neuroendocrine tumour and
not preoperatively presumed situs inversus totalis. Despite significant advancements in the treatment and management
of small intestine neuroendocrine tumours, which improved patient outcomes, diagnosing these tumours continues to
be a substantial challenge. This study aids in keeping a broader mindset on practical grounds, while concluding cause for
intestinal obstruction in cases of multiple presumptions
Received: 11.07.2025 | Revised: 14.11.2025 | Accepted: 30.12.2025
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