A REPORT OF A VERY RARE CASE: SITUS INVERSUS TOTALIS IN A 14-YEAR-OLD BOY

Background and Situs inversus or situs transversus is a rare congenital condition where abdominal organs are positioned in a transverse manner, as in front of a mirror. Its prevalence is less than one in 10/000. This paper is intended to report one such case. Patient's history: A fourteen-year-old boy referred to the clinic with complaints of leftward abdominal pain beneath the navel, nausea and vomiting. Early diagnosis of acute appendicitis was made after clinical examinations, laboratory tests and sonography. Radiography reports revealed the shift of heart to the right of chest, confirming the diagnosis of Dextrocardia. Gastric bubble and spleen were observed on the right and liver and cholecyst on the left with sonography. Pancreas was also positioned on the opposite side. LLQ results indicated acute appendicitis on the left. Clinical findings and paraclinic measures rendered the certain diagnosis of situs inversus totalis. The patient finally underwent left appendectomy. Normally, situs inversus is accompanied with dextrocardia and major vessels dislocation and its prognosis is good. This condition with levocardia is less common and amounts to one in 22/000, with a likelihood of increasing congenital cardiac diseases. In the reported case, no particular problem came up after surgery. Inverted anatomical condition and the atypical history of situs inversus make the early diagnosis difficult in these patients. Accurate history and clinical examinations and reliance on imaging techniques in traumatic cases can reduce and minimize medical errors in treating such rare cases.