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打破常规:一例镜像右位心患者成功实施胆囊切除术

Reversing the Norm: Successful Cholecystectomy in a Patient With Situs Inversus.

作者信息

Nassr Bahaa, Nassr Hasan, Allouzi Abdullah, Abdalla Abubakar, Shaheen Talal, Alkhatabi Ammar, Alkhatabi Osama

机构信息

General Surgery and Surgical Oncology, Al Salam Health Medical Hospital, Riyadh, SAU.

College of Medicine, Sulaiman Alrajhi University, Al Bukairiyah, SAU.

出版信息

Cureus. 2024 May 9;16(5):e59957. doi: 10.7759/cureus.59957. eCollection 2024 May.

Abstract

Situs inversus totalis (SIT), affecting 1 in 6,000 to 10,000 individuals, involves a complete reversal of chest and abdominal organs. About one-third of SIT cases coincide with primary ciliary dyskinesia, leading to diverse symptoms. Surgical challenges arise in procedures like liver transplantation and biliary interventions due to organ abnormalities. This case study explores cholecystitis in a patient with SIT, offering insights crucial for navigating complexities in treating this congenital anomaly. A 34-year-old Arab female, who was a known SIT case, came to the hospital complaining of abdominal pain in the left upper quadrant. After conducting a chest X-ray and an abdominal ultrasound, the patient was diagnosed with cholecystitis. She then underwent a planned cholecystectomy to remove her gallbladder. SIT presents challenges when it comes to procedures such as laparoscopic cholecystectomy (LC). Nevertheless, the proficiency of skilled surgeons, meticulous preoperative planning, and strict adherence to surgical principles render the execution of LC on patients with SIT both achievable and secure. The successful completion of over 120 cases serves as evidence of the adaptability and precision that can be achieved through surgery for individuals with SIT.

摘要

全内脏反位(SIT),发病率为六千分之一至万分之一,表现为胸腔和腹腔器官完全反转。约三分之一的SIT病例合并原发性纤毛运动障碍,导致多种症状。由于器官异常,肝移植和胆道介入等手术面临挑战。本病例研究探讨了一名SIT患者的胆囊炎,为应对这种先天性异常治疗中的复杂性提供了关键见解。一名34岁的阿拉伯女性,已知患有SIT,因左上腹疼痛前来医院就诊。在进行胸部X光和腹部超声检查后,患者被诊断为胆囊炎。随后她接受了计划性胆囊切除术以切除胆囊。在进行诸如腹腔镜胆囊切除术(LC)等手术时,SIT会带来挑战。然而,熟练外科医生的专业技能、细致的术前规划以及严格遵守手术原则,使得对SIT患者实施LC手术既可行又安全。超过120例手术的成功完成证明了通过手术治疗SIT患者可以实现适应性和精确性。

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