The 20-year-old girl was found to have a heart defect on the right side, the patient was confused, the doctor explained

According to E Hospital doctors, this is a rare case because the patient's organs are completely reversed. The patient's heart and stomach are on the right side, while the liver and appendix are on the left, completely opposite to normal.

Phung Van Quyen, M.D., Department of Digestive Surgery, Hospital E, said that the patient was hospitalized with clear signs of appendicitis such as: severe abdominal pain in the pelvis area, nausea, and gradually increasing pain. and continuously, the pain moves down to the lower abdomen... However, for normal people, when appendicitis pain will be in the right iliac fossa, while patients will have pain in the left iliac fossa, this can easily cause confusion. Diagnostic.

Through clinical examination and results of tests, abdominal ultrasound, and abdominal CT scan, doctors determined that the patient had localized peritonitis due to a purulent appendix on the background of a rare inverted viscera. Therefore, it is necessary to come up with a quick treatment plan to avoid complications that endanger the patient's life.

According to medical history, a few days ago, the patient had abdominal pain but did not go to the doctor. The pain was increasing in the left iliac fossa area, vomiting, epigastric pain then spreading to the lower abdomen with fever... the patient was taken to Hospital E by his family for examination and treatment.

After consultation, the doctors assessed this as a difficult and complicated surgery, on the basis of the patient's completely inverted organs. MScNT Phung Van Quyen explained that the phenomenon of viscera inversion is a condition in which tissues and internal organs in the chest and abdomen are inverted and reflected in the sagittal plane compared to their normal position.

Visceral inversion can be complete or just a few organs. This is a rare defect, with a rate of about 0.001% - 0.01%, of which about 5-10% have accompanying congenital heart defects; About 4% of viscera inversion cases may have appendicitis, the rest have completely normal lives, not affecting the patient's health.

The surgery took about 60 minutes, the doctors chose laparoscopic appendectomy to treat the patient's damage. The advantage of laparoscopic appendectomy is that it almost completely resolves the pus cavity and removes the appendix. Intraoperative complications and postoperative complications are low and post-operative recovery is fast and safe for the patient.

According to Dr. Mai Van Luc - Department of Kidney, Urology and Andrology Surgery, E Hospital, surgery on a patient with completely inverted anatomy will have many risks and difficulties when making diagnoses. sick.

First, when doing a clinical examination, the doctor only examines the right side, ignoring the left side, which risks missing damage, leading to late appendicitis causing peritonitis or ruptured appendix...

Second, during surgery, for patients with inverted viscera during surgery, doctors will have to perform reverse operations such as reverse trocal port operation, placing a reverse laparoscopic system...

When entering the abdomen, doctors discovered that the entire colon, liver, spleen, stomach, and appendix were all reversed. The appendix turned behind the cecum, so a retrograde appendectomy had to be performed. Therefore, doctors must examine and evaluate before surgery, during surgery, and after surgery, which requires in-depth expertise and experience to ensure patient safety.

Doctor Mai Van Luc recommends that appendicitis is an emergency condition and needs to be treated promptly to avoid dangerous complications. For people with inverted viscera, the diagnosis and treatment of appendicitis becomes even more complicated and risky.

There are cases of appendicitis in patients with viscera inversion, the doctor can only diagnose when we think of some signs that need attention such as: the patient has abdominal pain in the left iliac fossa accompanied by a cardiopulmonary X-ray. see an inverted image of the heart; Patients with a history of being diagnosed with viscera inversion require careful evaluation and examination.

Therefore, when there are signs of appendicitis, patients need to immediately go to reputable medical facilities for timely diagnosis and treatment. Arbitrarily taking antibiotics or pain relievers can lead to dangerous complications.

In this patient, after surgery, the doctors advised the patient and his family to clearly understand the medical condition, especially the future health considerations for the patient.

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