Acute appendicitis in patient with situs inversus totalis

Abstract

Introduction: Situs inversus totalisand acute left appendicitis are rare conditions, their prevalence, estimated to be 1 /10,000 births, the male female ratio is 1.5:1.

Objective: Describe a clinical case of situs inversus totalis with acute appendicitis.

Material and methods: A descriptive, retrospective, clinical case presentation of situs inversus totalis with acute appendicitis was conducted.

Results: The case of a male patient of 41 years, who entered the Surgery Service of the Hospital of the Ecuadorian Institute of Social Security of Latacunga, it referred pain of great intensity located in left fosa, in the physical examination was clinical signs of acute inflammatory abdomen were found in this area. Imaging studies confirmed the diagnosis of situs inversus totalis and acute left appendicitis. The situation of the cecal appendix in the left iliac pit, perforated acute appendicitis and peritonitis was checked in the surgery, with appendectomy, cleaning and drying of the abdominal cavity plus drainage placement. It evolved successfully, itwas graduated to the day, without postoperative complications.

Conclusions: In any patient with suspected left-based inversus situs and/or acute appendicitis, a tomography, radiological test of choice for the diagnosis of these conditions, whose sensitivity is approximately 93 % and specificity of 98 %, is recommended. Treatment options for left-side appendicitis are the same as in cases of usual location, open or laparoscopic appendectomy may be performed. The laparoscopic approach is feasible and useful for assessing differential diagnoses and solving different coexisting pathologies.