On May 28, information from E Hospital said that recently, this unit received and successfully operated on a patient with appendicitis peritonitis using laparoscopic appendectomy.

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

Specifically, a 20-year-old female patient was admitted to the hospital with obvious signs of appendicitis such as: severe abdominal pain in the pelvic area, nausea, increasing and continuous pain, pain moving to the lower abdomen...

However, for normal people, when appendicitis occurs, the pain will be in the right iliac fossa, while for patients, the pain will be in the left iliac fossa, which can easily cause confusion in diagnosing the disease.

MSc. Dr. Phung Van Quyen - Department of Digestive Surgery, E Hospital said that through clinical examination and test results, abdominal ultrasound, abdominal CT scan, doctors determined that the patient had localized peritonitis due to purulent appendix on the background of the patient having rare situs inversus. Therefore, it is necessary to provide a quick treatment plan to avoid complications that endanger the patient's life.

According to Master, Doctor of Medicine Phung Van Quyen, situs inversus is a condition in which the organs, tissues, and internal organs in the chest and abdomen are reversed and reflected vertically compared to their normal position. Situs inversus can be complete or just a few organs.

This is a rare malformation, with a rate of about 0.001% - 0.01%, of which about 5-10% have congenital heart defects; about 4% of situs inversus cases may have appendicitis, the rest have a completely normal life, not affecting the patient's health.

After consultation, the doctors assessed this as a difficult and complicated surgery, on the basis of the patient's completely reversed organs.

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

According to Dr. Mai Van Luc - Department of Urology and Andrology Surgery, E Hospital, surgery on patients with complete anatomical situs inversus will have many risks and difficulties when making a diagnosis.

Firstly, when performing a clinical examination, if the doctor only examines the right side and ignores the left side, there is a risk of missing lesions, leading to late appendicitis causing peritonitis or appendiceal rupture...

Second, during surgery, for patients with situs inversus, doctors will have to perform reverse operations such as reverse trocal port operations, reverse endoscopic device placement, etc.

When entering the abdomen, the doctors discovered that the entire colon, liver, spleen, stomach, and appendix were all reversed. The appendix was twisted behind the cecum, so a retrograde appendectomy had to be performed. Therefore, doctors had to examine and evaluate before, during, and after surgery, requiring deep expertise and experience to ensure patient safety.

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

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