Anesthetic management of a geriatric patient with situs inversus totalis with bilateral varicose veins for left-sided Trendelenburg's operation with bilateral superficial ligation of perforators

Abstract

Situs inversus is featured by the switching of the organs to the opposite side of the body. When associated with dextrocardia, it is known as situs inversus totalis. This disease is a uncommon congenital anomaly and can lead to a diagnostic misperception for surgeons because of infrequent location of symptoms resulting in late diagnosis of known pathologies and operative complications because of changed anatomy. Varicose veins of leg, although being commonly reported, to be diagnosed specially in elderly can be notorious if associated with its complications such as ulcers, bleeding, and so on, and when associated with underlying medical illness. We report a rare case where these conditions coexisted. A 62-year-old woman presented with swelling in bilateral lower limbs with pain on walking with hypertension, type-2diabetes mellitus, and situs inversus totalis electively posted for left-sided Trendelenburg’s operation with bilateral superficial ligation of perforators, which we managed successfully under sole epidural anesthesia.