Monday, July 12, 2010

Pain in Left Lower Abdomen may be Due to Appendicitis

Appendix, a vestigial structure found attached to the beginning part of large intestine called caecum. It is usually situated inside the right lower abdomen. Inflammation in it give rise to what is called appendicitis. The pain arising out of it is usually felt in the right lower abdomen. Commonly, for a right lower abdominal pain first disease suspected is appendicitis. If, pain arises from similar location in the left side, appendicitis is often not considered. But, in rare cases appendix may be found in the left lower abdomen instead of right. The condition is called situs invertus, where the normal left side contents of abdomen are found in the right side and vice versa. The clue to it, before other imaging investigations is location of heart. The heart is normally located in the left side inside the chest, but in situs invertus is found in the right. This will be evident from the examination of heart sounds, which will be heard in the right side.

X-rays examination, ultrasonogram and CT etc will definitely prove it. So, in left sided pain simulating appendicitis the heart should be examined to arrive at a provisional clinical diagnosis of left sided appendicitis before imaging investigations. Of course, the treatment is no different from right sided appendicitis. Situs invertus as such does not pose any special threat or predisposes to diseases in comparison to their normal counterparts. Here, one thing has to be remembered by the patient is that he/she should mention the condition of situs invertus, if is already aware it.
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