Recurrent Appendicitis with Situs Inversus Totalis Treated by Laparoscopic Appendectomy：A Case Report

Abstract

A 14-year-old male patient visited the emergency room complaining of left lower abdominal pain and vomiting. He had a history of bronchiectasis (suspected Kartagener’s syndrome) and of having received conservative treatment for appendicitis. Abdominal computed tomography showed situs inversus totalis and an enlarged appendix in the lower left abdomen. Recurrent acute appendicitis with situs inversus totalis was diagnosed, and a semi-emergency surgery was performed. The operation was initiated, and the surgeon, assistant, and monitor were placed in positions opposite to the usual placement positions for laparoscopic appendectomy. Surgery in cases of situs inversus totalis is sometimes difficult because of the anatomical peculiarity, but laparoscopic appendectomy is considered as being safe for acute appendicitis in these cases.