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Cited 9 time in webofscience Cited 9 time in scopus
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Successful access to the ampulla for endoscopic retrograde cholangiopancreatography in patients with situs inversus totalis: a case report

Authors
Lee, Jung MinLee, Jae MinHyun, Jong JinChoi, Hyuk SoonKim, Eun SunKeum, BoraJeen, Yoon TaeChun, Hoon JaiLee, Hong SikKim, Chang Duck
Issue Date
28-Nov-2017
Publisher
BIOMED CENTRAL LTD
Keywords
Situs inversus; Endoscopic retrograde cholangiopancreatography; Choledocholithiasis
Citation
BMC SURGERY, v.17
Indexed
SCIE
SCOPUS
Journal Title
BMC SURGERY
Volume
17
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/4426
DOI
10.1186/s12893-017-0307-x
ISSN
1471-2482
Abstract
Background: Although various endoscopic techniques in situs inversus have been reported, endoscopic retrograde cholangiopancreatography (ERCP) in patients with situs inversus is always challenging even for an experienced, endoscopist. We performed ERCP using two different techniques, and compare the merits of each technique. Case presentation: A 74-year-old woman presented, with epigastric pain and jaundice for 3 days. Computed tomography revealed diffuse dilatation of the biliary tree, with multiple intrahepatic duct and common bile duct (CBD) stones, in addition to situs inversus totalis. ERCP was performed twice for CBD stone to remove the CBD stones using two techniques. For the first technique used, the patient was placed in a prone position with the endoscopist on the right side of the table. First, the endoscope was rotated 180 degrees counterclockwise in the stomach, and was then shortened by turning 180 degrees the counterclockwise again in the duodenum. For the second technique, we assessed the second portion of the duodenum by following the lesser curvature, while slowly turning the endoscope clockwise. Conclusion: We present an unusual case of biliary stones in a patient with situs inversus who was treated using modified ERCP techniques.
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Lee, Jae Min
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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