1/6. Laparoscopic cholecystectomy and appendectomy in situs inversus totalis.situs inversus totalis is an uncommon anatomic anomaly that complicates diagnosis and management of acute abdominal pain. Expedient diagnosis of common intraperitoneal disease processes such as biliary colic, acute appendicitis and diverticulitis is often delayed as a result of seemingly incongruous physical findings. We present the case of a young woman with prior emergency room visits for complaints of a vague left upper quadrant abdominal pain. An ultrasound performed on her third presentation revealed visceral situs inversus with cholelithiasis and dilated intra- and extrahepatic biliary ducts. Standard laparoscopic cholecystectomy and cholangiography with a mirror-image surgical approach was performed successfully and without complication.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/6. Prescreen evaluation of situs inversus patients.situs inversus is a congenital visceral malrotation anomaly that occurs in approximately 2 per 10,000 live births, but it may go unrecognized until discovered during emergency surgery. The differential diagnosis in situs inversus patients may not be readily seen in the emergency setting. Historical symptoms include reversed locations for common physical complaints, whereas physical signs can be used to diagnose and treat these patients. Laboratory data may also be used to diagnose and treat patients with this anomaly. This study was prompted by a postmortem investigation of a patient with situs inversus and dextrocardia. Several other cases of congenital malrotation, with attention to anatomical variants coupled with medical data, provide guidelines in prescreen evaluation and medical/surgical treatment of similar patients. Careful attention to laboratory and radiologic findings are paramount to quality patient care and prevention of complications. Educating these patients about their malrotation would also aid in future treatment.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
3/6. situs inversus totalis.The etiology of situs inversus totalis remains uncertain. However, the literature establishes that isolated situs inversus totalis is usually asymptomatic in the neonate. This case study illustrates the importance of physical assessment skills in identifying situs inversus totalis in the neonate. Current research may reveal the etiology of this rare but fascinating abnormality.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/6. dextrocardia with situs inversus: a case report.We present a 24-year-old lady who reported at the radiology department, UBTH benin City for a chest radiograph, as part of her pre-employment medical examination. She was asymptomatic, her past medical history was not significant and physical examination revealed an apex beat located on the 5th right intercoastal space. The chest radiograph confirmed dextrocardia and also revealed the gastric air bubble on the right, which was suggestive of situs inversus totalis. barium meal examination confirmed the right-sided position of the stomach, in keeping with situs inversus. ultrasonography revealed a left sided liver and gall bladder, with a right sided location of the spleen.- - - - - - - - - - ranking = 15.205698252304keywords = physical examination, physical (Clic here for more details about this article) |
5/6. Laparoscopic appendectomy in a female patient with situs inversus: case report and literature review.BACKGROUND: situs inversus is an uncommon condition caused by a single autosomal recessive gene of incomplete penetration. A potential diagnostic dilemma can occur in the young female patient with a history of situs inversus who presents with pelvic pain. methods: A 32-year-old multiparous patient with a known history of situs inversus presented with complaints of pelvic pain. A medical history and full physical examination were indicative of possible endometriosis. RESULTS: The patient underwent an operative laparoscopy, which revealed stage II pelvic endometriosis based on the American fertility Society Revised classification for endometriosis (R-AFS), with appendicular and periappendicular adhesions involving the cecum. Ablation of endometriosis and an appendectomy were performed. CONCLUSION: The authors believe the laparoscopic approach to an appendectomy is ideal in a patient with situs inversus and should be performed at the time of laparoscopy performed for another reason.- - - - - - - - - - ranking = 15.205698252304keywords = physical examination, physical (Clic here for more details about this article) |
6/6. cholecystectomy in situs viscerum inversus totalis. Does laparoscopy increase the pitalls?Situs viscerum inversus is a rare condition in which the organs are transposed, totally or partially, to the opposite side of the body. Normally, there are no organ dysfunctions. Clinically, symptoms of cholelithiasis may be clear but confused by the location of the gallbladder on the opposite side. We report the case of a 43-year-old female with occasional colic pain in the epigastrium radiating to the right side and subscapular region, particularly after lunch. The laboratory findings showed normal values and, at physical examination, deep palpation of the abdomen in the epigastric region provoked pain. x-rays, ultrasonography, and CT scan showed the presence of multiple gallstones and the situs viscerum inversus of the abdominal organs. The only pathological finding was cholecystolithiasis. Laparoscopic cholecystectomy was judged advisable. Situs viscerum inversus is not a contraindication for laparoscopic cholecystectomy. This abnormal anatomical condition may create some initial difficulty for the surgeons, because of the inverted position of the organs. The peculiarity of our case is the unlikely site of the abdominal pain, located in the epigastrium and on the right side although the patient had situs viscerum inversus. Laparoscopic cholecystectomy can be performed on the left-sided gallbladder proceeding with the "american technique". In difficult cases, open cholecystectomy can be unavoidable.- - - - - - - - - - ranking = 15.205698252304keywords = physical examination, physical (Clic here for more details about this article) |