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Thursday, January 9, 2020

"Situs inversus" in a gun-shot injury.

It was during the second JVP uprising in the 1980s. I was Consultant Surgeon, GH Kandy. On my way to Kandy from my home in Avissawella, after spending the week end with my family, I would leave home at 6am for the one and a half hour drive to Kandy. Many a time I have passed a tyre burning on the  highway, cremating a body. We just drove around the smoldering tyres and went on our way. Gun-shot injuries were frequent. One casualty day I had to operate on a gunshot wound on the upper right side of the abdomen. I expected to see a massive injury to the liver deep to the skin wound. I was pleasantly surprised to see, the spleen under the wound in the skin, with a puncture mark on it, bleeding. This was easily controlled by removing the  spleen. The patient had a 'situs inverses' where the internal organs were arranged in a mirror image. If the patient had a normal anatomical arrangement, the right lobe of the liver would have been in that position and the patient would have not survived the journey to the hospital, due to massive bleeding from the liver. This patient recovered and went home, still fearful of the JVP cadres in his area.
Destiny plays strange tricks.

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