What happened, in summary

A 61-year-old man presented with abdominal distension and blood and mucus in his stool. He had situs inversus totalis, meaning his chest and abdominal organs were positioned as a mirror image of the usual anatomy, as well as major residual disability from a previous cerebral infarction. Colonoscopy found an obstructing rectal mass, and biopsy confirmed adenocarcinoma.

A multidisciplinary team planned surgery carefully because of his unusual anatomy, anemia and severe cerebrovascular disease. He underwent laparoscopic radical resection using a Hartmann procedure with sigmoid colostomy. Postoperative pathology confirmed moderately differentiated rectal adenocarcinoma.

He recovered smoothly after surgery and was discharged. During 24 months of follow-up, no tumor recurrence or metastasis was found.