ERCP in complete situs inversus viscerum using a “mirror image” technique

García-Fernández, Francisco Javier; Infantes, J. M.; Torres, Y.; Mendoza, Felipe; Alcazar, F. J.

doi:10.1055/s-0030-1255813

Cited by 25 publications

(23 citation statements)

References 2 publications

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“…This is the first report of EP in a patient with situs inversus. In our case, all the procedures were feasible in the usual prone position without using a mirror image technique or special instruments including sphincterotome. In conclusion, EP can be carried out safely in patients with situs inversus, although more cases are needed to evaluate the procedural difficulty and adverse event rates.…”

mentioning

confidence: 75%

Successful endoscopic papillectomy in a patient with situs inversus

Sekino

Nakajima

Kubota

2016

Digestive Endoscopy

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mentioning

confidence: 75%

Successful endoscopic papillectomy in a patient with situs inversus

Sekino

Nakajima

Kubota

2016

Digestive Endoscopy

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“…were in non-English literature and 2 were not relevant. Of the rest 30 results, data about 32 patients with situs inversus was reported (2)(3)(4)(5)(7)(8)10,. To the best of our literature search, this is the first report of successful endoscopic therapy for a case of traumatic pancreatic disruption.…”

Section: Discussionmentioning

confidence: 99%

“…In our search, two patients had procedures in surgically altered anatomy for the diagnosis of CBD stone and anastomotic stricture in one patient each (16,20). Of the rest 30 cases, the commonest indication for ERCP in situs inversus was CBD stone (18 patients), malignant biliary obstruction (6 patients), biliary stricture (2 patients) while one patient each had portal biliopathy, ampullary adenoma, chronic calcific pancreatitis and normal CBD (2)(3)(4)(5)(7)(8)10,(12)(13)(14)(15)(17)(18)(19)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). This suggests that pancreatic endotherapy has been done very infrequently.…”

Section: Discussionmentioning

confidence: 99%

“…The literature also describes a mirror-image method which places the patient in the right lateral decubitus position. In this technique, the equipment lies behind the patient with all manoeuvres performed inversely during ERCP (8). A different approach involves keeping the patient supine on the table with the endoscopist on the left of patient (9).…”

Section: Discussionmentioning

confidence: 99%

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Successful ERCP for management of traumatic pancreatic disruption in a patient with situs inversus

Sharma

Malik

Mandavdhare

et al. 2018

IRDR

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Endoscopic retrograde cholangio-pancreatography (ERCP) is an important tool for treatment of pancreaticobiliary diseases. However, ERCP may be difficult in patients who have altered gastrointestinal anatomy due to congenital or surgical reasons. A 40-year-old male with HIV infection presented with abdominal pain following abdominal trauma. The patient was diagnosed to have traumatic pancreatic injury and underlying situs inversus. The pancreatic fluid collection was drained using radiology guided pigtail placement done for the symptoms of abdominal pain and vomiting. The resulting external pancreatic fistula was successfully managed with ERCP and stenting. The patient improved with disappearance of ascites and resolution of pigtail output which was then removed. We report the technique used for ERCP in this patient. We also review the literature on pancreatic endotherapy in patients with situs inversus. The published literature suggests that with modifications in the standard ERCP technique like mirror image technique, 180 degree turn technique, left lateral technique these patients can be managed successfully.

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“…Different techniques have been used for biliary access in patients with situs inversus such as, a "mirror image" ERCP technique with the endoscopic maneuvers performed in an inverse fashion, or positioning the patient lying prone on her right side [2,3]. In our case biliary access is easily achievable in patients with situs inversus by keeping the patient in the left oblique position, along with maneuvering the duodenoscope and sphincterotome towards the inversed position of the ampulla.…”

Section: Case Studymentioning

confidence: 96%

Comparison between Carbon Dioxide and Air Insufflation in Colonoscopy: A Systematic Review and Meta-Analysis Based On Randomized Control Trials

Coronel¹,

Korkischko²,

Bernardo³

et al. 2017

JGPLD

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Situs inversus totalis is an extremely rare autosomal recessive disorder occurring in 0.01% of the population. The reversal of visceral organs poses technical difficulties for therapeutic intervention during endoscopic retrograde cholangiopancreatography (ERCP). We describe a unique case of a patient with situs inversus who underwent therapeutic ERCP for management of choledocholithiasis. Case StudyA 37-year-old woman with a history of situs inversus totalis, complex congenital cyanotic heart disease, polysplenia and laparoscopic partial cholecystectomy performed 10 years prior, presented with post-prandial right upper quadrant pain and nausea. She had elevated bilirubin, and computed tomography (CT) scan showed cholelithiasis in the remnant gallbladder. An endoscopic retrograde cholangiopancreatography (ERCP) was performed for possible choledocholithiasis. Patient was placed in the left oblique position. There was altered anatomy of the gastric curvature and the ampulla was located in the 2 o'clock position. Biliary access was achieved by keeping the scope in the long position, rotating the duodenoscope 180o, and rotating the sphincterotome to the right side. Cholangiogram showed a mirror image of the transposed biliary tree and remnant gallbladder with filling defectsconsistent with cholelithiasis. Biliary sphincterotomy was performed and balloon sweep showed biliary stone fragments, consistent with choledocholithiasis. She subsequently underwent cholecystectomy for removal of the remnant gallbladder.Situs inversus is a rare benign congenital anomaly that may pose difficulty during ERCP [1]. Different techniques have been used for biliary access in patients with situs inversus such as, a "mirror image" ERCP technique with the endoscopic maneuvers performed in an inverse fashion, or positioning the patient lying prone on her right side [2,3]. In our case biliary access is easily achievable in patients with situs inversus by keeping the patient in the left oblique position, along with maneuvering the duodenoscope and sphincterotome towards the inversed position of the ampulla.

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ERCP in complete situs inversus viscerum using a “mirror image” technique

Abstract: UCTN-Unusual cases and technical notes E317 García-Fernández FJ et al. ERCP in complete situs inversus viscerum using a "mirror image" technique … Endoscopy 2010; 42: E316-E317 This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Cited by 25 publications

References 2 publications

Successful endoscopic papillectomy in a patient with situs inversus

Successful endoscopic papillectomy in a patient with situs inversus

Successful ERCP for management of traumatic pancreatic disruption in a patient with situs inversus

Comparison between Carbon Dioxide and Air Insufflation in Colonoscopy: A Systematic Review and Meta-Analysis Based On Randomized Control Trials

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