Ulus Travma Acil Cerrahi Derg. 2010; 16(3): 268-270

Karýn sol alt kadran aðrýsýnýn nadir bir sebebi: Situs inversus totalisli hastada akut apandisit

Erdal Karagülle¹, Emin Türk¹, Erkan Yýldýrým², Gökhan Moray^1
1Baþkent Üniversitesi Týp Fakültesi, Genel Cerrahi Ana Bilim Dalý, Ankara
²Baþkent Üniversitesi Týp Fakültesi, Radyodiagnostik Ana Bilim Dalý, Ankara

Sað alt kadran aðrýsýyla baþvuran hastada ilk akla gelen tanýlardan biri akut apandisittir. Apendektomi en sýk yapýlan acil cerrahi ameliyattýr. Karýn sol alt kadran aðrýsýnýn çok deðiþik nedenleri olabilir. Situs inversus totalis embriyonik geliþim sýrasýnda meydana gelen bir anomalidir. Bu anomalide karýn ile toraks içi organlar ters yerleþimlidir. Bu olgu sunumunda sol alt kadran aðrýsýyla baþvuran, incelemeler sonrasý situs inversus totalis ile birlikte akut apandisit tanýsý konulan olgu tartýþýldý. Hekimlere yanlýþ taný ve tedavi sonrasý açýlan davalar göz önüne alýnýrsa, acil serviste yapýlan tüm incelemelerin yeterli deðerlendirilmesi ve eldeki radyolojik imkanlardan doðru ve yeterince yararlanýlmasý gerektiði düþüncesindeyiz.

Anahtar Kelimeler: Akut apandisit, bilgisayarlý tomografi; situs inversus totalis; karýn aðrýsý; sol alt kadran.

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A rare cause of left lower quadrant abdominal pain: acute appendicitis with situs inversus totalis

Erdal Karagülle¹, Emin Türk¹, Erkan Yýldýrým², Gökhan Moray^1
1Department Of General Surgery, Baskent University, Ankara, Turkey
²Department Of Radiology, Baskent University, Ankara, Turkey

For the patient admitted with right lower quadrant abdominal pain, acute appendicitis is the most frequently considered diagnosis. Appendectomy is the most common of all emergency operations. However, there may be several reasons for left lower quadrant abdominal pain. Situs inversus totalis is an anomaly that occurs during embryonic development when intraabdominal and intrathoracic organs have reverse localization. In this case report, we present a patient who was admitted with left lower quadrant abdominal pain and was diagnosed as situs inversus totalis and acute appendicitis. In view of the legal repercussions for doctors as a result of erroneous diagnosis and treatment, we think that adequate evaluation of the studies in the emergency service is important and that the radiological investigations have to be used appropriately and sufficiently.

Keywords: Acute appendicitis, computed tomography; situs inversus totalis; abdominal pain; left lower quadrant.

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