ERCP and endoscopic sphincterotomy in patients with situs inversus

Venu, Rama P.; Geenen, Joseph E.; Hogan, Walter J.; Johnson, G. K.; Taylor, Amy; Stewart, Edward T.; Jackson, Andrew

doi:10.1016/s0016-5107(85)72220-1

Cited by 20 publications

(20 citation statements)

References 6 publications

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“…This patient also was equipped with a pacemaker for his cardiac problem. Although successful endoscopic extraction of ductal stone has been reported, it cannot be denied that this procedure is extremely difficult and not without risks [10,20,21]. The authors managed to perform a diagnostic ERCP with success, but in view of anticipated difficulties and risks associated with proceeding further, endoscopic extraction with ERCP was abandoned.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic exploration of common bile duct in difficult choledocholithiasis

Tai

Tang

et al. 2004

Surg Endosc

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Section: Discussionmentioning

confidence: 99%

Laparoscopic exploration of common bile duct in difficult choledocholithiasis

Tai

Tang

et al. 2004

Surg Endosc

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“…In general, ERCP is carried out with the patient in the prone or left lateral decubitus position. We found a few case reports where ERCP had been carried out successfully in a patient with situs inversus by altering the position of the patient and the endoscopist 6–9 . In these reports, the patient was in the right lateral decubitus position, 6–9 and the endoscopist was on the right side of the patient 6,7,9 .…”

Section: Discussionmentioning

confidence: 99%

“…Venu et al . reported three successful cases of ERCP in patients with situs inversus 6 . All three of their patients were intubated endotracheally.…”

Section: Discussionmentioning

confidence: 99%

“…We found a few case reports where ERCP had been carried out successfully in a patient with situs inversus by altering the position of the patient and the endoscopist. [6][7][8][9] In these reports, the patient was in the right lateral decubitus position, [6][7][8][9] and the endoscopist was on the right side of the patient. 6,7,9 In some cases, after the endoscope reached the duodenum, the patient was rotated to the prone, recumbent/prone, or recumbent/supine position.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9] In these reports, the patient was in the right lateral decubitus position, [6][7][8][9] and the endoscopist was on the right side of the patient. 6,7,9 In some cases, after the endoscope reached the duodenum, the patient was rotated to the prone, recumbent/prone, or recumbent/supine position. 6,8 Venu et al reported three successful cases of ERCP in patients with situs inversus.…”

Section: Discussionmentioning

confidence: 99%

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Supine Position Endoscopic Retrograde Cholangiopancreatography in a Patient With Situs Ambiguous With Polysplenia

Byun¹,

Jahng²,

Song³

et al. 2010

Digestive Endoscopy

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A 58-year-old woman complained of painless jaundice. The serology showed total bilirubin 10.6 mg/dL with direct bilirubin of 7.0 mg/dL. Abdominal computed tomography (CT) scan disclosed an abnormal arrangement of the abdominal viscera and dilation of the biliary tree. A nearly 1.4 cm-sized periampullary mass was seen. These findings are compatible with situs ambiguous with polysplenia and were suggestive of a periampullary tumor. Due to her unusual anatomical features, the patient underwent an endoscopic retrograde cholangiopancreatography (ERCP) in the supine position instead of in the conventional prone position. ERCP showed that the common bile duct (CBD) diameter was increased to 20 mm. Microscopic findings of the biopsy specimen of papillary mass were compatible with an adenocarcinoma of the ampulla of Vater. The clinical stage was stage IA (T1N0M0). Eight days later, a papillectomy was carried out by endoscopic snare resection. Six months later, follow-up studies, including ERCP, abdominal CT and 18-fluorodeoxyglucose positron emission tomography ((18) -FDG PET)-CT scan, showed no evidence of recurrence. Although the success rate of supine position ERCP may be influenced by the extent of the intestinal malrotation and the position of the duodenum, we conclude that supine position ERCP can be carried out effectively in a patient with situs anomaly.

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Endoscopic retrograde cholangiopancreatography in a patient with complete situs inversus viscerum: A case report and literature review

2021

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Complete situs inversus viscerum (SIV) is a rare congenital condition, defined by a left‐right transposition of all viscera with dextroposition of the heart. In patients with SIV that requires endoscopic intervention, namely endoscopic retrograde cholangiopancreatography (ERCP), the left‐right coordination can be technically demanding even with skilled endoscopist. We report a case of a patient with underlying SIV who presented with septic shock secondary to ascending cholangitis compounded with a malaria infection. Despite the ascertainment of a relatively large Common Bile Duct (CBD) stone, ERCP and stenting were pursued as an initial treatment modality in view of the clinical presentation of cholangitis and COVID‐19‐related delays in surgical intervention at our center. This case is unique as the patient was maintained in a supine position throughout the procedure. The patient underwent a successful ERCP procedure followed by a CBD Exploration and cholecystectomy 2 weeks later. A key factor that contributed to the success of this procedure was the combined utilization of a rotatable sphincterotome and extractor balloon which assisted with cannulation and shortening manoeuvre of the duodenoscope to facilitate biliary stenting.

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ERCP and endoscopic sphincterotomy in patients with situs inversus

Cited by 20 publications

References 6 publications

Laparoscopic exploration of common bile duct in difficult choledocholithiasis

Laparoscopic exploration of common bile duct in difficult choledocholithiasis

Supine Position Endoscopic Retrograde Cholangiopancreatography in a Patient With Situs Ambiguous With Polysplenia

Endoscopic retrograde cholangiopancreatography in a patient with complete situs inversus viscerum: A case report and literature review

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