Fibroadenoma Excision under Thoracic Segmental Spinal Anaesthesia in Isolated Situs Inversus Totalis: A Case Report

Abstract

Situs inversus totalis is a rare congenital positional anomaly with a predicted incidence of 1: 10,000 amongst the general population described by the transposition of the abdominal and thoracic visceral structures. Local infiltration of the breast is a common technique for fibroadenoma of small sizes. However, its efficacy, including duration of action as well as the extent, can be unreliable and surgeon dependent. Unless otherwise contraindicated, the regional technique of thoracic segmental spinal anesthesia has been proven to be a safe and effective method for even major surgeries including laparoscopic cholecystectomy, breast lumpectomy and abdominal surgeries. Multiple regional anesthetic techniques are available and should be used according to the requirement of the surgery as well as the skill and knowledge of the performing anesthetist. We discuss here, a case of fibroadenoma in a patient with isolated situs inversus totalis, operated under thoracic segmental spinal anesthesia.