A 78-year-old man in Culiacán, Mexico, spent weeks being treated for what looked like a stomach complaint. He had dull, continuous pain in the upper left side of his abdomen, black stools, bloating, and a 5-kilogram weight loss. He was given acid-suppressing medication and antibiotics and sent home.
He was, in fact, developing a ruptured appendix. His organs were arranged in a mirror image, a congenital condition called situs inversus totalis, and his appendix sat on the left side of his abdomen instead of the right. By the time surgeons opened him up, the appendix had perforated, his small bowel had a hole in it, and infection had seeded his liver.
