Resumo

VILLABONA, Andrea Nathalia et al. Acute appendicitis in an adult patient with abnormal intestinal rotation and a cardiovascular defect: case presentation and literature review. rev. colomb. cir. [online]. 2018, vol.33, n.2, pp.220-227. ISSN 2011-7582.  https://doi.org/10.30944/20117582.65.

Acute appendicitis is the most frequent surgical pathology at the emergency departments and its diagnosis is predominantly clinical. Around 2/3 of the patients with this pathology present typical pain, located in the right lower quadrant. However, abdominal pain in the left lower quadrant secondary to acute appendicitis is of infrequent presentation. It is important to know the existence of certain pathologies that can explain the cause for this entity, to take them into account when examining a patient. These are the intestinal malrotation and, most frequently, situs inversus. Both of them explain the abdominal pain secondary to appendicitis in a different location from the classic presentation, in order to make an accurate diagnosis and treatment so complications can be prevented. Additionally, it is important to perform complementary studies in these patients to discard other alterations or malformations, such as cardiovascular defects, because they are related to defects in the gastrointestinal formation and rotation in approximately 27% of the cases.

We present the case of a young male, with abdominal pain that begins in the epigastrium with posterior localization in the left lower quadrant. He presents signs of peritoneal irritation and abnormal laboratory tests. Imaging studies are performed and confirm the presence of left sided acute appendicitis and intestinal malrotation. During the patient’s follow-up, a transesophageal echocardiography was performed due to chest pain, which shows aortic valve insufficiency secondary to aortic bivalve valvulopathy.

Palavras-chave : appendicitis; diagnosis; appendectomy; laparotomy; situs inversus; heart defects, congenital.

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