Murshid Mohsin Yahya, AlShamrani Abdulmalik, Hayash Fatimah, Ansari Farrukh Alim
Department of General Surgery, Hera General Hospital, Al Madinah Al Munawarah Rd, Makkah 24227, Saudi Arabia.
J Surg Case Rep. 2025 Aug 29;2025(8):rjaf653. doi: 10.1093/jscr/rjaf653. eCollection 2025 Aug.
Situs inversus totalis (SIT) is a rare congenital anomaly involving mirror-image reversal of thoracic and abdominal organs, which may complicate the diagnosis and management of acute abdominal conditions due to atypical symptom localization. This report describes a 23-year-old male who presented with lower abdominal pain and vomiting. Clinical examination revealed tenderness in the left iliac fossa and laboratory findings showed leukocytosis. A chest X-ray revealed dextrocardia, raising suspicion for situs inversus totalis, which was confirmed by contrast-enhanced CT demonstrating an inflamed appendix in the left iliac fossa. The patient underwent laparoscopic appendectomy with modifications to port placement and operative positioning to accommodate the reversed anatomy. The procedure was completed without complication, and the patient recovered uneventfully. This case highlights the importance of early recognition of anatomical anomalies in patients with atypical abdominal pain and supports the use of laparoscopy as both a diagnostic and therapeutic approach in SIT.
全内脏转位（SIT）是一种罕见的先天性异常，涉及胸腹部器官的镜像反转，由于症状定位不典型，可能会使急性腹部疾病的诊断和治疗复杂化。本报告描述了一名23岁男性，他出现下腹痛和呕吐症状。临床检查发现左下腹压痛，实验室检查结果显示白细胞增多。胸部X线显示右位心，这引发了对全内脏转位的怀疑，对比增强CT证实左下腹有发炎的阑尾，从而确诊。患者接受了腹腔镜阑尾切除术，对端口放置和手术体位进行了调整，以适应反转的解剖结构。手术顺利完成，患者恢复良好。该病例强调了早期识别非典型腹痛患者解剖异常的重要性，并支持将腹腔镜检查作为全内脏转位患者的诊断和治疗方法。
