Situs inversus is a rare congenital anomaly that results in the transposition of the abdominal organs, leading to atypical clinical presentations, such as left-sided appendicitis. Acute appendicitis is the most common cause of right iliac fossa pain; however, its occurrence on the left side is exceedingly rare and often leads to diagnostic delays, which may result in serious complications such as peritonitis if not promptly addressed. Imaging modalities, particularly computed tomography (CT), play a critical role in the anatomical and pathological diagnosis, thereby guiding appropriate surgical management. We present the case of a 67-year-old patient with a history of ileocecal tuberculosis, myocardial infarction, and ischemic stroke, who was admitted with left iliac fossa pain, initially suspected to be due to sigmoiditis. A CT scan revealed situs inversus with high-positioned left-sided appendicitis, prompting the indication for urgent laparoscopy. Surgical exploration confirmed a retrocecal appendicitis with minimal peritoneal effusion, and an appendectomy was performed.
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http://dx.doi.org/10.1093/jscr/rjaf130 | DOI Listing |
J Surg Case Rep
March 2025
Department of Visceral Surgery and Digestive Oncology A, Mohammed VI University Hospital, BP 4806 Oujda Universite, 60049 Oujda, Morocco.
Situs inversus is a rare congenital anomaly that results in the transposition of the abdominal organs, leading to atypical clinical presentations, such as left-sided appendicitis. Acute appendicitis is the most common cause of right iliac fossa pain; however, its occurrence on the left side is exceedingly rare and often leads to diagnostic delays, which may result in serious complications such as peritonitis if not promptly addressed. Imaging modalities, particularly computed tomography (CT), play a critical role in the anatomical and pathological diagnosis, thereby guiding appropriate surgical management.
View Article and Find Full Text PDFCureus
November 2024
General Surgery, Ankara Etlik City Hospital, Ankara, TUR.
Acute appendicitis typically causes right lower quadrant pain, but in elderly patients with comorbidities, it can present atypically, complicating diagnosis. This case highlights a rare presentation, mimicking sigmoid diverticulitis. A 70-year-old man with chronic heart failure, arrhythmia, and renal failure presented with two days of left lower quadrant pain.
View Article and Find Full Text PDFArq Gastroenterol
November 2024
Universidad Científica del Sur, Lima, Peru.
Background: Worldwide, acute appendicitis (AA) is the most frequent cause of acute surgical abdomen. Although typically associated with pain migrating to the right iliac fossa, AA can also manifest with pain in the left lower quadrant, often linked to anatomical anomalies. Latin America and the Caribbean (LAC) have the highest incidence of AA compared to other regions of the world.
View Article and Find Full Text PDFRadiol Case Rep
December 2024
Department of Urology, School of medicine, Tehran University of Medical Sciences, Tehran, Iran.
Radiol Case Rep
October 2024
Addis Ababa University, College of Health Sciences, Department of Radiology, Addis Ababa, Ethiopia.
Intestinal nonrotation is the most common type of mid-gut anomaly where the small bowel predominantly occupies the right side of the peritoneal cavity, while the colon primarily resides on the left. The occurrence of acute appendicitis in mid-gut anomalies poses a serious diagnostic challenge due to unprecedented clinical and imaging features. Here we present a 20-year-old female who came to the hospital with left lower abdominal pain of 3 weeks duration, referred with a diagnosis of tubo-ovarian abscess.
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