Left-sided acute appendicitis in a patient with situs inversus totalis: a case report

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.