Presentation
Abdominal pain, vomiting, and low-grade fever for 2 days
Patient Data
In the left iliac fossa is an enlarged, fluid-filled retrocecal appendix measuring 10 mm in short axis with peripheral enhancement. There is also periappendiceal fat stranding and post-contrast surrounding soft tissue enhancement, representing acute appendicitis.
Additionally, there is a change in the position of solid organs and bowel from the right to the left side and vice versa, with liver on the left and spleen on the right. The heart also shows dextrocardia, indicating situs inversus totalis.
Case Discussion
As described above, the anatomic position of the bowel and solid organs is reversed, including the appendix, which is located in the left iliac fossa.
The patient underwent an abdominal exploratory laparotomy, during which a large pus-filled, inflamed retrocecal appendicitis was found in the left lower quadrant, and an appendectomy was performed.
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