Delayed diagnosis of abdominal pain in patient with situs inversus totalis in emergency department

RATIONALE Abdominal pain is one of the most common complaints for patients in emergency department. It's difficult to make an accurate diagnosis by emergency physician in time, especially in patients with situs inversus totalis. PATIENT CONCERNS A patient with acute exacerbation of chronic left upper quadrant abdominal pain.DIAGNOSES:: cholangiolithiasis with situs inversus totalis. INTERVENTIONS laparoscopic cholecystectomy and laparoscopic exploration of common bile duct. OUTCOMES The patient had an uneventful recovery. LESSONS High suspicion and adequate evaluation are important for diagnosis in patients with abdominal pain and situs inversus totalis in emergency department, and physical examination, electrocardiogrphy and radiological investigations are necessary.