A rare acute abdomen case: Acute appendicitis in a patient with situs inversus totalis

Rıfat Peksöz; Mustafa Yeni; Ali Dablan; Esra Dişçi

doi:10.28982/josam.570128

Authors

Rıfat Peksöz https://orcid.org/0000-0003-4658-5254
Mustafa Yeni https://orcid.org/0000-0003-2384-2094
Ali Dablan https://orcid.org/0000-0003-4198-4416
Esra Dişçi https://orcid.org/0000-0003-3657-3620

DOI:

https://doi.org/10.28982/josam.570128

Keywords:

Acute appendicitis, Situs inversus totalis, Left lower quadrant pain, Computed tomography

Abstract

Acute appendicitis is the most frequent disease requiring urgent surgery in the world. It may sometimes occur in atypical locations, such as the lower left quadrant of the abdomen. If previously unknown, some conditions such as situs inversus totalis make diagnosing acute appendicitis difficult. In those cases, surgeons primarily consider diverticulitis, gynecological diseases, or urinary pathologies, which present with lower left quadrant pain. Direct abdominal radiography, ultrasonography and computed tomography are the auxiliary imaging methods in the diagnosis of the disease. Dextrocardia and the observation of the gastric fundus gas in the right quadrant in direct abdominal radiograph are key features of situs inversus totalis. Considering the anatomical variation, laparoscopic exploration is recommended in these patients. We hereby present a forty-eight-year-old female patient with situs inversus totalis who was diagnosed with acute appendicitis.

Downloads

Download data is not yet available.

References

Sammalkorpi HE, Mentula P, Leppäniemi A. A new adult appendicitis score improves diagnostic accuracy of acute appendicitis-a prospective study. BMC Gastroenterology. 2014;14:114.

Merter A, Bilecik T, Mayır B, Doğan U, Koç Ü, Oruç T. Laparoscopic Appendectomy in a Patient with Situs Inversus Totalis: Case Report. FÜ Sağ Bil Tıp Derg. 2014;28(3):145.

Jaffe BM, Berger DH. The appendix. In: Brunicardi FC, Andersen KD, Billiar RT, Dunn LD, Hunter GC, Pollock RE, editors. Schwartz’s Principles of Surgery. 8th ed. New York: McGraw-Hill; 2005. p. 1119-1137.

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;16:5598-602.

Oh JS, Kim KW, Cho HJ. Left-sided appendicitis in a patient with situs inversus totalis. J Korean Surg Soc. 2012;83:175-8.

Koç A, Sönmez Y, Balaban O. Anaesthetic Management for Appendectomy in a Patient with Situs Inversus Totalis. Turkish Journal of Anesthesia & Reanimation. 2016;44:105-7.

Karagülle E, Türk E, Yildirim E, Moray G. A rare cause of left lower quadrant abdominal pain: acute appendicitis with situs inversus totalis. Turkish Journal of Trauma & Emergency Surgery. 2010;16:268-70.

Kamiyama T, Fujiyoshi F, Hamada H, Nakajo M , Harada O, Haraguchi Y. Left-sided acute appendicitis with intestinal malrotation. Radiation Medicine. 2005;23:125-7.

Nelson MJ, Pesola GR. Left lower quadrant pain of unusual cause. The Journal of Emergency Medicine. 2001;20:241-5.

Sands SS, Taylor JF. Prescreen evaluation of situs inversus patients. International surgery 2001;86:254-8.

Yaghan RJ, Gharaibeh KI, Hammori S. Feasibility of laparoscopic cholecystectomy in situs inversus. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2001;11:233-7.

Demangone DA. EKG findings associated with situs inversus. Journal of Emergency Medicine 2004;27:179-81.

Ünal O, Haberal K, Çolak A. Left sided acute appendicitis in a patient with situs inversus totalis, Türk Radyoloji Derg. 2018;37(1):13-5.

Yılmaz Ö, Bayrak V, Çallı İ, Demir A. Differential Diagnosis in Left Lower Quadrant Pain: Acute Appendicitis in Patients with Situs İnversus. Sakarya Med J. 2014;4(2):93-5.