13例腹腔内脏转位畸形合并腹部疾病的诊断与治疗

Diagnosis and treatment of abdominal diseases accompanying situs inversus： report of 13 cases

目的探讨腹腔内脏转位畸形对合并腹部疾患临床诊治的影响。方法回顾性分析2012-2016年北京大学第一医院13例腹腔内脏转位畸形案例的临床资料，评价腹腔内脏转位畸形对合并腹部疾病诊治过程的影响。结果经腹部CT确诊的腹腔内脏转位畸形共13例，占同期腹部cT检查者的比例为1．5／10000，其中体检偶然发现6例，合并泌尿系统症状4例，消化系统症状3例。保守治疗或随诊8例，手术治疗5例，其中2例为肾切除，1例为胰十二指肠切除，1例为腹腔镜胆囊切除，1例为ERCP。术后患者均无并发症，恢复良好。结论腹腔内脏转位畸形在临床罕见，多因腹部其他疾患就诊时偶然发现，对其合并腹腔疾患的诊治并无特殊影响。

Objective To explore the impact of abdominal situs inversus on the diagnosis and treatment of abdominal diseases. Methods Clinical data and course of 13 abdominal situs inversus eases from January 2012 to December 2016 were retrospectively analyzed. Results A total of 13 cases accounting for 1.5/10 000 of all cases who had abdominal CT were diagnosed situs inversus. 6 of them were diagnosed for routine physical examination, 4 of them for urinary tract symptoms, and the other 3 for digestive complaints. Conservative treatment or follow-up was prescribed for 8 patients who were asymptomatic and healthy; Five patients received operation, including 2 nepbrecctomy, 1 panereatico duodenectomy, 1 laparoscopic cholecystectomy, and 1 endoscopic retrograde cholangiopancreatography. All the cases recovered uneventfully. Conclusions Abdominal situs inversus is rare, non-disease entity, usually an incidental finding during clinical examination. It does not affect the therapeutic principle of concurrent primary disease.