Man with 'reverse organs' gets appendectomy at Mumbai's JJ Hospital

Mumbai: When a 51-year-old vegetable vendor from Raigad recently came to state-run JJ Hospital with chronic abdominal pain that many local doctors had not been able to cure for almost a year, doctors here found a fairly common cause: Appendicitis.

What had made the diagnosis of Dagdu Shigvan's problem difficult was a "rare" anomaly called situs inversus totalis, a condition in which all the organs are in reverse or in a mirror position from their original position. "His heart, liver, stomach, were all on the opposite side," said Dr Ajay Bhandarwar, who heads the surgery department of JJ Hospital in Byculla.

Shigvan had known for a few years that his heart was on the "opposite side". During a scan he underwent in 2014 when he was first diagnosed with diabetes, doctors in Mahad explained that his heart was on the right side.

"My pain started a year back, but it was transient. Four months back, it became difficult to bear," said Shigvan, who has been shifted to the general ward after undergoing a minimally invasive appendix removal surgery on Friday.

Shigvan met several doctors in and around his village in the last few months, and while a week or so of medication would make him feel better, the pain would return. "As we ran out of money and hope, we decided to come to JJ Hospital in Mumbai last month," said his son Akshay. Here too, Shigvan was put through multiple scans such as CT, MRI, ultrasound, but the doctors couldn't pinpoint a cause for the pain.

Given his different anatomy, the surgery team at JJ Hospital then suggested a laparoscopic exploration so that doctors could look for the 'problem' using a camera whose images could be magnified several times over. "The evaluation showed his liver on the left upper abdomen instead of right, stomach was on the right, and the appendix was on the left side,'' said Dr Bhandarwar.

What makes Shigvan a special case is that he is only the third patient in the history of JJ Hospital with a complete situs inversus totalis. The incidence of situs inversus totalis is 1 in 10,000 population.

"Usually, we have patients with dextrocardia (heart on the right side) or some with one or two transposed organs, but these three patients had a complete inversion," said Dr Bhandarwar. The other two patients with situs inversus totalis underwent removal of appendix and gallbladder.