Background:
Situs inversus is often detected incidentally in adults during imaging for an acute surgical emergency. We present a case of acute appendicitis in an adult who was previously unaware about his situs anomaly. A laparoscopic approach is helpful to deal with this condition.

Case Report: A 16-year-old girl was admitted with history of acute abdominal pain. Clinically, she was diagnosed as acute appendicitis without any localized peritonitis. Subsequent imaging studies and lapartomy confirmed the diagnosis of situs inversus and acute left-sided appendicitis. She successfully underwent laparotomic appendectomy. Her postoperative recovery was uneventful. Morever, the patient had lagre and hemorragic cytes in every two ovaries that excisioned during the operation. Technically, more challenging because of the reverse laparoscopic view of the anatomy, the laparoscopic diagnosis and management of acute appendicitis is indicated in situs inversus.

Key words: Congenital Anomaly, Situs inversus totalis, Appendicitis, Laparotomy.