Bhattarai, Ashish MohanDevkota, YogendraBhattarai, Ayush Mohan2026-02-062026-02-062022https://hdl.handle.net/20.500.14572/4555Ashish Mohan Bhattarai Department of Radiodiagnostics, Nobel Medical College, Biratnagar, Morang, Nepal https://orcid.org/0000-0001-5072-0944 Yogendra Devkota Department of Surgery, Nobel Medical College, Biratnagar, Morang, Nepal Ayush Mohan Bhattarai Department of Medicine, Nepalese Army Institute of Health Sciences, Sanobharyang, Kathmandu, Nepal https://orcid.org/0000-0001-6730-0292Abstract: Appendicitis rarely presents with an left lower abdominal pain especially when the intestine is non-rotated or malrotated. Its diagnosis becomes quite troublesome to clinicians and delays prompt intervention. Non-rotation is the most common type of intestinal malrotation. Here, we present a case of a 40-year-old female with previously undiagnosed intestinal non-rotation with left lower abdominal pain and features of localised peritonitis. Abdominal ultrasonography and multidetector computerised tomography showed left-sided appendicitis with intestinal non-rotation. Diagnostic laparoscopy followed by explorative laparotomy and appendectomy was performed. Clinicians and surgeons are usually trained to diagnose and operate on right-sided appendix, thus, diagnosing and promptly intervening on left-sided appendicitis is quite challenging. Left-sided appendicitis must be kept in mind if a patient presents with left lower abdominal pain. Timely radiological scans like ultrasonography and computerised tomography scans help in prompt diagnosis in these cases.en-USappendicitiscase reportperitonitis.Article