All internal organs and duodenal trans cancer 2 cases of gallbladder stones.docVIP

 PAGE \* MERGEFORMAT 4 All internal organs and duodenal trans cancer 2 cases of gallbladder stones [Keywords:] all visceral inversus, duodenal cancer, gallbladder stones All internal organs also called mirror trans people, is the heart, lung, stomach, intestines, liver, spleen, gall bladder, kidney and other organs of the normal anatomic position and the opposite, as normal as the image in the mirror, such extremely rare exceptions [1]. I study in the Nanjing Military Region General Hospital had treated 2 cases during the period, are as follows. 1 Clinical data Patient 1, female, 60 years old, skin, sclera for jaundice, dark urine 40 d hospital, past the “cholecystitis,” a history of 40 years. Was outside the hospital examinations showed all visceral inversus. Checkup: T 36.8 , BP 130 / 80 mmHg, body skin, mucous membranes and sclera jaundice, heart in the right side of the chest, abdomen is soft, xiphoid, the left upper quadrant abdominal tenderness, no rebound tenderness, liver and upper bound of 5 in the left intercostal space mid clavicular line. shifting dullness negative, both lower extremities without edema. auxiliary examination: serum total bilirubin (TB), direct bilirubin (DB) were significantly increased. outside the hospital chest X-ray, ECG were prompted dextrocardia. duodenal ampullary tips outside the hospital MRI placeholder. I B-School, CT are prompted anti-bit wide internal organs, liver and bile duct expansion, consider the ampulla lesions. upper gastrointestinal barium meal examination of descending part of duodenum pressure prompted the shift, in line with ampullary account bit of the disease, visceral inversus. Diagnosis: obstructive jaundice, periampullary cancer, anti-bit wide internal organs. anesthesia pancreaticoduodenal resection. pathological diagnosis: moderately differentiated adenocarcinoma of duodenal papilla violation of full-thickness intestinal wall, pancreas, common bile duct margin and no margin of gastrointesti