Cecal volvulus in situs inversus totalis accompanied with pancreatic malrotation

Situs inversus totalis is a rare anomaly that is characterized by mirror image anatomy of the abdominal and thoracic organs. This anomaly is often discovered incidentally in adults during an emergent surgical procedure or by radiologic investigations performed for other medical reasons. Cecal volvulus is a surgical emergency requiring urgent laparotomy. Coexistence of these two abnormalities poses a challenge in establishing a definitive diagnosis because of the alteration of normal anatomy; this may cause a delay in emergent surgical intervention. We present a case of situs inversus totalis complicated by cecal volvulus. In our case, a different type of pancreatic malrotation, which we called "folded", also accompanied these abnormalities. To our knowledge, this is the first case in the literature involving situs inversus totalis, cecal volvulus, and a "folded" type of pancreatic malrotation.