Salgado OJ, González IMI, Castillo MJR, Olvera HHG, Cuevas HLF, Torices EE

Language: Spanish
References: 14
Page: 129-132
PDF size: 444.24 Kb.

ABSTRACT

Introduction: Is a rare congenital malformation, with a prevalence rate in the United States about 0.01%. It is an abnormal alignment of the organs, being placed in a mirror like alignment which demand special attention during the diagnostic protocol, this is because it’s difficult to come up to an accurate diagnostic of these patients and even more difficult to plan invasive procedures in patients with such condition. Objective: Report a case of this condition that events in the Regional Hospital «1o de Octubre», ISSSTE in which the diagnostic of acute appendicitis in a patient with situs inversus totalis. Was asseverated clinically, radiologically and intraoperative. Material and methods: A clinical case of a 53 years old male patient which is brought in the emergency room after initiating with abdominal pain of 24 hours of evolution time. First installing in the periumbilical area with irradiation to the left iliac fossa, with an initial diagnosis of complicated diverticular disease, afterward an abdominal computerized axial tomography was requested as well as an abdominal ultrasound, afterwards a laparoscopic appendectomy was performed. A phase II appendicitis was the postoperatory diagnostic. The surgical procedure was performed without any complication and the patient had an adequate clinical evolution. Results and conclusions: In patients with abdominal pain located in the left iliac fossa its important to make a differential diagnostic, it is necessary to suspect a nosocomial entity such as acute appendicitis. The laparoscopic appendectomy in patients with situs inversus totalis was technically more difficult to perform due to the mirror like anatomy.

REFERENCES

1. Oh JS, Kim KW, Cho HJ. Left-sided appendicitis in a patient with situs inversus totalis. A case report. J Korean Surg Soc. 2012; 83: 175-178.

2. Akbulut S, Ulku A, Senol A, Tas M, Yagmur Y. Left-sided appendicitis: review of 95 published cases and a case report. World J Gastroenterol. 2010; 16: 5598-5602.

3. Nelson MJ, Pesola GR. Left lower quadrant pain of unusual cause. J Emerg Med. 2001; 20: 241-245.

4. Akbulut S, Caliskan A, Ekin A, Yagmur Y. Left-sided acute appendicitis with situs inversus totalis: review of 63 published cases and report of two cases. J Gastrointest Surg. 2010; 14: 1422-1428.

5. Contini S, Dalla Valle R, Zinicola R. Suspected appendicitis in situs inversus totalis: an indication for a laparoscopic approach. Surg Laparosc Endosc. 1998; 8: 393-394.

6. Palanivelu C, Rangarajan M, John SJ, Senthilkumar R, Madhankumar MV. Laparoscopic appendectomy for appendicitis in uncommon situations: the advantages of a tailored approach. Singapore Med J. 2007; 48: 737-740.

7. Bertaud S, Badvie S. Contrary to expectation--a case of left-sided acute appendicitis. BMJ Case Reports. 2012; doi:10.1136/bcr-2012-006552.

8. Golash V. Laparoscopic management of acute appendicitis in situs inversus. J Minim Access Surg. 2006; 2: 220-221.

9. Seifmanesh H, Jamshidi K, Kordjamshidi A, Delpisheh A, Peyman H, Yasemi M. Acute left-sided appendicitis with situs inversus totalis: a case report. Am J Emerg Med. 2010 Nov; 28(9): 1058.e5-7

10. Ratani RS, Haller JO, Wang WY, Yang DC. Role of CT in left-sided acute appendicitis: case report. Abdom Imaging.; 27: 18-19.

11. Yang C, Liu H, Lin H, Lin J. Left-sided acute appendicitis: a pitfall in the emergency department. J Emer Med. 2011; 3: 1-3.

12. Cissé M, Touré AO, Konaté I, Dieng M, Ka O, Touré FB et al. Appendicular peritonitis in situs inversus totalis: a case report. J Med Case Rep. 2010; 4: 134.

13. Israelit S, Brook OR, Nira BR, Guralnik L, Hershko D. Left-sided perforated acute appendicitis in an adult with midgut malrotation: the role of computed tomography. Emerg Radiol. 2009; 16: 217-218.

14. Tawk CM, Zgheib RR, Mehanna S. Unusual case of acute appendicitis with left upper quadrant abdominal pain. Int J Surg Case Rep. 2012; 3(8): 399-401.