Situs Inversus Totalis with Perforated Duodenal Ulcer: A Case Report

A bstract Situs inversus totalis is a condition when thoracic along with abdominal organs is mirrored (reversed). The diagnosis of this condition is often an incidental one discovered during the investigation of another associated ailment. Although it may not be a life threatening condition, the recognition of its presence holds importance in patients undergoing surgical/radiological interventions. We present a case report of a 34-year-old chronic smoker and occasional alcoholic male patient who presented to the emergency department with a 10 h history of sudden onset, severe upper abdominal pain associated with nausea and multiple episodes of non-bilious vomiting. Abdominal examination revealed diffused guarding and rigidity with absent bowel sounds. After resuscitation and subsequent biochemical and radiological investigations, he was diagnosed as a case of situs inversus totalis with hollow viscous perforation. Exploratory laparotomy with Graham’s repair was done for duodenal perforation with an uneventful postoperative course.