Dubai: A Nigerian medical tourist who flew in for a gall bladder stone removal surgery to the UAE was diagnosed for the first time with a case of Situs Inversus Totalis’ and treated accordingly.
Situs Inversus Totalis is an extremely rare condition that occurs in 0.01 per cent of the global population. In patients with this genetic condition, the organs in the chest and abdomen are found in a mirror image of their normal position. People with this condition often have other abnormalities like congenital heart disorders, lung problems, sinusitis, etc.
During a routine ultrasound before gall bladder stone removal surgery, doctors at the Medeor Hospital, Dubai made this unusual discovery in the 39-year old Patience Okoduwa who had flown in from Lagos, Nigeria.
Unusual Discovery
Okoduwa had sought treatment for abdominal pain at different hospitals in her home country before choosing the UAE but had not found any right help. She zeroed in on Dubai’s Medeor Hospital. At the hospital, she underwent an ultrasound test to confirm the presence of gall bladder stones. To the radiologist’s surprise, the ultrasound revealed that Okoduwa also suffered from the rare, congenital organ reversal condition.
Heart on the right side
Elaborating on the case, Dr Jaswant Ahuja, Specialist Radiologist at the hospital said: “During the scan, I found transposition of the organs. The liver and gallbladder, which are normally located on the right side, were seen on the left side of the abdomen. The heart was located on the right side. The condition is called Situs Inversus with Dextrocardia,” said Dr Ahuja, adding that this is an anomaly that is rarely seen.
Upon learning about the diagnosis for the first time, Okoduwa and her husband, Emmanuel were surprised. She said, “I have undergone three caesarean sections in the past. Over the years, I have visited a couple of big hospitals for gall bladder stone complaint. I am surprised that nobody has been able to detect this till we came here,” said the emotional patient.
Improvising on the surgery
Surgeons operating on this patient had to modify their approach, following the diagnosis of organ reversal as the medical procedures. Surgery procedures are conventionally planned keeping in mind that all major organs like the heart and liver on the left side. In this case, the procedure had to be adapted.
Laparoscopy
Dr Arindam Ghosh who performed his first surgery on patient with Situs Inversus Totalis, elaborated: “This was a challenging procedure as it required a complete reorientation mentally to execute the procedure without complications. The surgeon’s non-dominant left hand would have to work as the main operating hand, a task that was not easy. The patient also had other complications like a hernia and severe adhesions in the whole abdomen that needed to be cleared. We performed the surgery laparoscopically using mirror-image keyholes. All the instruments used in the surgery were placed on the mirror-image side. The surgery was completed in two and half hours,” he explained.
Apart from Dr Ghosh who is Consultant Gastroinstestinal Surgeon at Medeor Hospital in Dubai, Dr Dildar Hussain, Specialist General Surgeon, Dr Pinkesh Laxmikant Thakkar, Specialist General and Laparoscopic Surgeon, Dr Abdul Aneez, Specialist Anesthesiologist, and Belson Lukose, Manager, Operation Theatre, were part of the surgical team
Couple buy house in Dubai
Upon discharge of the patient, Emmanuel, her husband expressed his gratitude. He said: “We appreciate the kindness shown to us throughout our visit.” He added that their first visit to the country had inspired them to buy an apartment here so that they could call Dubai their second home. Thanks to Okoduwa’s quick recovery, the family was also able to visit to Burj Khalifa and other tourist attractions in the UAE.
Valuable Advice
Dispensing valuable advice to people who may have this condition. Dr Ghosh, cautioned, “Once a person is diagnosed with Situs Inversus Totalis, it is recommended that he or she carry a badge revealing their disorder. A badge would come in handy during a medical emergency as the doctors would be able to help them quickly.”
