Situs inversus totalis (SIT) is a rare congenital anomaly characterized by dextrocardia associated with reverse anatomical position of abdominal and thoracic organs. We report a case of SIT in Malagasy male patient aged 41-year-old admitted to Emergency Unit for an acute abdominal pain located in left iliac fossa. Preoperative chest X-ray showed an image of dextrocardia with reverse location of gastric bubble under the right hemidiaphragm. CT scan showed a situs inversus totalis with an abscess appendicitis located in the left iliac fossa associated with right-sided cardiac position and reversed location of abdominal organs. Patient underwent laparotomy with appendicectomy. Postoperative period was uneventful.
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