Abstract
The differential diagnosis of left lower quadrant abdominal pain in an adult man includes,
among others, sigmoid diverticulitis; leaking abdominal aortic aneurysm; renal colic;
epididymitis; incarcerated hernia; bowel obstruction; regional enteritis; psoas abscess;
and in this rare instance, situs inversus with acute appendicitis. We report a case
of situs inversus totalis with left-sided appendicitis and a brief review of the literature.
There were several subtle indicators of total situs inversus present that were missed
by the physicians and surgeons who initially evaluated the patient prior to surgery.
Computed tomography scan with contrast, however, revealed the diagnosis immediately,
and treatment was successfully initiated.
Keywords
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References
- Abdominal pain in the ED.Am J Emerg Med. 1995; 13: 301-303
- Abdominal pain.Am J Surg. 1976; 131: 219-223
- Acute abdomen in the surgical emergency room.Acta Chir Scand. 1982; 148: 141-148
Fales WD, Overton DT. XXXX In: Tintinalli JE, ed. A study guide in emergency medicine. 4th edn. Dallas, TX: McGraw-Hill; 1996:217.
Greenfield RH, Henneman RL. XXXX In: Rosen P, Barkin R, Danzl DF, et al., eds. Emergency medicine: concepts and clinical practice. 4th edn. St. Louis, MO: Mosby; 1998;2005.
- The incidence of acute appendicitis.Acta Chir Scand. 1982; 148: 45-49
Moore KL. The developing human: clinically oriented embryology. 4th edn. XXXX: WB Saunders; 1998:228–36.
- Perforated appendix in situs inversus viscerum.S Afr Med J. 1976; 50: 141-143
- Acute left-sided appendicitis.Br J Surg. 1969; 56: 233-234
- Position of vermiform appendix as ascertained by analysis of 10,000 cases.J Anat. 1933; 47: 277-283
- Defects in the determination of left-right asymmetry.J Med Genet. 1996; 33: 498-503
- Surgery in situs inversus.Ann Surg. 1949; 129: 244-286
- The genetics of transposition of the viscera.Q J Med. 1938; 31: 479-493
- Acute appendicitis in complete situs inversus.Neth J Surg. 1985; 37: 117-118
- Recognizable patterns of human malformations. 3rd edn. WB Saunders Co, Philadelphia, PA1982
- Birth defects encyclopedia. Blackwell Scientific Publications, Inc, Cambridge, MA1990
- Genetic factors in visceral asymmetry in the development and pathological changes of the lungs, heart, and abdominal organs.Arch Pathol. 1949; 47: 556-593
- Seventy-one thousand human appendix specimens.Am J Proctol. 1963; 14: 365-381
- Mirror-image dextrocardia with situs inversus.Circulation. 1995; 91: 1602-1603
- Cardiac rhythms in dextrocardia.Am J Cardiol. 1970; 25: 420-427
Article info
Publication history
Accepted:
September 26,
2000
Received in revised form:
September 1,
2000
Received:
October 12,
2000
Identification
Copyright
© 2001 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.
