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Báo cáo y học: " Situs inversus totalis with perforated duodenal ulcer: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Situs inversus totalis with perforated duodenal ulcer: a case report. | Tayeb et al. Journal of Medical Case Reports 2011 5 279 http www.jmedicalcasereports.eom content 5 1 279 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Situs inversus totalis with perforated duodenal ulcer a case report Mohammad Tayeb1 Faiz Mohammad Khan1 and Fozia Rauf2 Abstract Introduction Situs inversus is an uncommon anomaly. Situs inversus viscerum can be either total or partial. Total situs inversus also termed as mirror image dextrocardia is characterized by a heart on the right side of the midline while the liver and the gall bladder are on the left side. Patients are usually asymptomatic and have a normal lifespan. The exact etiology is unknown but an autosomal recessive mode of inheritance has been speculated. The first case of perforated duodenal ulcer with situs inversus was reported in 1986 here we report the second case of this nature in the medical literature. Case presentation A 22-year-old Pakistani man presented with severe epigastric and left hypochondrial pain. Examination and investigations chest X-ray and ultrasonography confirm peritonitis in a case of situs inversus totalis. On exploratory laparotomy a diagnosis of situs inversus totalis with perforated duodenal ulcer was confirmed. Graham s patch closure of the duodenal ulcer was performed with absorbable sutures and a thorough peritoneal lavage was also performed an incidental appendectomy was also performed to avoid further diagnostic problems. Our patient had an uneventful recovery. Conclusions A diagnostic dilemma arises whenever abdominal pathology occurs in patients with situs inversus. Although an uncommon anomaly to choose a proper surgical incision site for abdominal exploration pre-operative recognition of the condition is important. Introduction Situs inversus first described by Aristotle in animals and Fabricius in humans 1 is an uncommon anomaly with an incidence varying from one in 4 000 to one in 20 000 live births 2 . Situs inversus viscerum can be either total or