Situs inversus totalis (SIT) is a rare condition with a genetic predisposition, wherein organs or organ systems are transposed from their normal sites to locations on the opposite side of the body (the mirror image of normal). The syndrome may include transposition of the thoracic viscera, the abdominal viscera, or more commonly, both. The incidence has been calculated variously as 1 in 6,000-35,000 live births. We present the case of a 22-year-old man with SIT with acute appendicitis. Patient was treated with laparoscopic appendicectomy which is invaluable in both diagnosis and treatment of such patients.

Femoral hernias, which are less common than inguinal hernias and more often found in females, occasionally contain more than just small intestine and omentum. Uncommon contents reported in femoral hernia sacs include caecum, appendix, Meckel's diverticulum (Littre hernia), testis, ovary, transverse colon and even stomach or kidney. Strangulation of femoral hernias containing appendix, small intestine and caecum, and Meckel's diverticulum are well reported in the literature. Here, we report a case of a male patient having bilateral femoral hernia with bilateral recurrent inguinal hernia. A huge, right-sided femoral hernia contained terminal ileum, appendix, caecum and ascending colon, which were irreducible but neither obstructed nor strangulated. The patient was operated on with a Pfannenstiel incision together with an infrainguinal incision. For reduction of content, an inguinal ligament was also incised. Bilateral preperitoneal, polypropylene mesh hernioplasty was performed along with rolled plug placement in the right femoral canal. The patient had an uneventful post operative recovery and no recurrence in 6 months of follow up.

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