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Left-sided appendicitis in a patient with situs inversus totalis
Joo Suk Oh1, Ki Wook Kim, Hang Joo Cho
1Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea School of Medicine, Uijeongbu, Korea.
Journal of the Korean Surgical Society
|September 15, 2012
Summary
Situs inversus totalis, a rare condition, complicates appendicitis diagnosis. Dextrocardia on chest X-ray in patients with left lower quadrant pain suggests left-sided appendicitis, aiding diagnosis and treatment.
Area of Science:
- Medical Science
- Surgical Science
Background:
- Situs inversus totalis is a rare congenital condition where thoracic and abdominal organs are mirrored.
- Appendicitis in situs inversus patients often presents atypically, typically in the left lower quadrant, making diagnosis challenging.
Observation:
- A case of left-sided appendicitis was diagnosed preoperatively in a situs inversus patient presenting with left lower quadrant pain.
- Dextrocardia, detected via chest X-ray, was a key indicator for suspecting left-sided appendicitis.
Findings:
- Abdominal computed tomography (CT) confirmed the diagnosis of appendicitis.
- The patient successfully underwent an emergent laparoscopic appendectomy.
Implications:
- Dextrocardia on chest X-ray in patients with left lower quadrant pain warrants suspicion for left-sided appendicitis.
- Prompt diagnosis via imaging (CT or sonography) and surgical intervention can prevent complications like perforation and abscess.
- Laparoscopic appendectomy in situs inversus presents unique anatomical challenges due to the mirrored organ arrangement.
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