全内脏转位患者的腹腔镜胆囊切除术：一例报告
Laparoscopic cholecystectomy in situs inversus totalis: a case report.
作者信息
McKay Damian, Blake Geoffrey
机构信息
The Department of Surgery, Daisy Hill Hospital, 5 Hospital Road, Newry, Co Down, BT35 8DR Northern Ireland.
出版信息
BMC Surg. 2005 Mar 17;5:5. doi: 10.1186/1471-2482-5-5.
BACKGROUND
Laparoscopic cholecystectomy is one of the commonest surgical procedures carried out in the world today. Occasionally patients present with undiagnosed situs inversus and acute cholecystitis. We discuss one such case and outline how the diagnosis was made and the pitfalls encountered during surgery and how they were overcome.
CASE PRESENTATION
A 32 year old female presented to our department with epigastric pain radiating through to the back. A diagnosis of acute cholecystitis in a patient with situs inversus totalis was made following clinical examination and radiological investigation. Laparoscopic cholecystectomy was subsequently performed and the patient made an uneventful recovery.
CONCLUSION
Situs inversus presenting with acute cholecystitis is very rare. The surgeon must appreciate that care should be taken to set up the operating theatre in the mirror image of the normal set-up for cholecystectomy, and that right handed surgeons must modify their technique to adapt to the mirror image anatomy.
背景
腹腔镜胆囊切除术是当今世界上最常见的外科手术之一。偶尔会有患者表现为未被诊断出的内脏反位和急性胆囊炎。我们讨论这样一个病例，并概述诊断是如何做出的，以及手术过程中遇到的陷阱和如何克服这些陷阱。
病例报告
一名32岁女性因上腹部疼痛放射至背部前来我院就诊。经过临床检查和影像学检查，诊断为全内脏反位患者的急性胆囊炎。随后进行了腹腔镜胆囊切除术，患者恢复顺利。
结论
内脏反位合并急性胆囊炎非常罕见。外科医生必须认识到，应注意按照胆囊切除术正常设置的镜像来布置手术室，并且右利手外科医生必须调整其技术以适应镜像解剖结构。
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