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首页> 外文期刊>The Internet Journal of Surgery >Laparoscopic Cholecystectomy In A Patient With Situs Inversus Totalis: Technical Difficulties and Possible Solutions.
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Laparoscopic Cholecystectomy In A Patient With Situs Inversus Totalis: Technical Difficulties and Possible Solutions.

机译：腹股沟逆行患者的腹腔镜胆囊切除术：技术难题和可能的解决方案。

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Situs inversus totalis is a rare anomaly characterized by transposition of organs to the opposite side of thorax and abdomen to form a mirror-image anatomy. These patients pose a technical challenge for surgeons even for commonly performed surgical procedures. We report a patient with situs inversus totalis for whom we performed laparoscopic cholecystectomy for the treatment of cholelithiasis with chronic cholecystitis. Diagnostic problems and technical difficulties faced by us during procedure are discussed along with experience of other authors available in the literature. Introduction Situs inversus totalis is a rare congential disorder occurring in 0.01% of the population.[1] It may be partial, where the transposition is confined to either the abdominal or the thoracic viscera, or complete, i.e. involving both cavities.[2] Change in anatomical position of organs not only gives rise to abnormal location of symptoms and signs, thus posing a difficulty in diagnosing the ailment, but also demands greater surgical skill. We report a case with complete situs inversus who presented with features of chronic cholecystitis and underwent laparoscopic cholecystectomy. Case report A 47-year-old female presented with colicky pain in the left upper abdomen associated with nausea and dyspepsia occurring occasionally for the last 4-5 months. No other symptoms were present and abdominal examination was unremarkable. Abdominal ultrasonography revealed situs inversus with the gall bladder lying on the left side and containing multiple calculi. The patient was planned for laparoscopic cholecystectomy using standard four-port technique. Four ports on the left side of the abdomen were mirror images of those used for a right-sided gall bladder (Fig. 1).
机译：共有骨反位是一种罕见的异常，其特征是器官移位到胸部和腹部的相对侧以形成镜像解剖结构。这些患者甚至对于通常执行的外科手术程序对外科医生也构成技术挑战。我们报告一名患者，我们进行了腹腔镜胆囊切除术治疗慢性胆囊炎的胆石症。讨论过程中我们面临的诊断问题和技术难题，以及文献中其他作者的经验。引言全反义齿是一种罕见的先天性疾病，发生在0.01％的人口中。[1]它可以是局部的，即转位仅限于腹部或胸腔内脏，也可以是完整的，即涉及两个腔。[2]器官解剖位置的改变不仅引起症状和体征的异常位置，从而给疾病的诊断带来了困难，而且还需要更高的手术技能。我们报告一例完全翻身，表现出慢性胆囊炎的特征并接受了腹腔镜胆囊切除术。病例报告一名47岁女性在最近4-5个月内偶发恶心和消化不良，左上腹部出现绞痛。没有其他症状出现，腹部检查无异常。腹部超声检查显示眼睑内翻，胆囊位于左侧，并有多处结石。该患者计划使用标准的四端口技术进行腹腔镜胆囊切除术。腹部左侧的四个端口是用于右侧胆囊的端口的镜像（图1）。

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