Clinical Images. An unusual case of appendicitis.

Situs inversus may be identified as an incidental finding when investigating abdominal pain in the acute emergency setting. We report a case of a 46-year-old man who presented with left-sided acute appendicitis on a background of situs inversus. The clinical presentation was left lower-quadrant pain. Clinically, the diagnosis of diverticulitis was made until review of plain-film imaging raised the possibility of situs inversus, and thus appendicitis. Cross-sectional imaging studies and laparoscopy confirmed the diagnosis of acute left-sided appendicitis. He underwent laparoscopic appendectomy with an uncomplicated postoperative course. Crown Copyright 2010. Published by Elsevier Inc. All rights reserved.