Successful endoscopic papillectomy in a patient with situs inversus

Sekino, Yusuke; Nakajima, Atsushi; Kubota, Kensuke

doi:10.1111/den.12662

Cited by 3 publications

(5 citation statements)

References 4 publications

(4 reference statements)

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“…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%

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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Section: Discussionmentioning

confidence: 99%

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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“…Currently, this approach is widely applied for various treatments such as common bile duct stone removal. However, there are a limited number of reports on ERCP in patients with situs inversus . Here, we report a patient with situs inversus who underwent Billroth‐I gastrectomy.…”

Section: Biliary Cannulation Using P‐wire For Patient With Situs Invementioning

confidence: 96%

“…In subjects with SIV, a mirror image of the normal anatomy makes it more difficult for the endoscopist to gain access to duodenal papilla. In previous reports, we found that most of the patients were placed in a left lateral position or prone position, which is the usual position in ERCP, and the endoscopist preferred to be on the right side of the operating table. Adjustments such as a 180° turn in the stomach or special techniques such as a “mirror image” were shown to contribute to maintenance of the duodenal papilla.…”

Section: Biliary Cannulation Using P‐wire For Patient With Situs Invementioning

confidence: 99%

Successful endoscopic retrograde cholangiopancreatography using pancreatic guidewire placement for biliary cannulation in a patient with situs inversus and Billroth‐I gastrectomy (with video)

et al. 2019

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We reported a 95‐year‐old man with cholangitis who underwent Billroth‐I gastrectomy. He was diagnosed with situs inversus viscerum and ERCP was performed. A stable field of view could not be secured due to anatomical factors (Billroth‐I gastrectomy) and strong respiratory variations. However, pancreatic duct cannulation was possible. A pancreatic guidewire was placed to achieve selective biliary cannulation. This stabilized the field of view. The catheter was inserted on the right side of the guidewire. Cannulation to the 1 o'clock direction achieved biliary cannulation. Intended procedure was completed safely in the present case.

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“…72 In the literature, several reports of successful endoscopic interventions can be found. These include endoscopic submucosal dissection of early gastric cancer, 72 PEG (percutaneous endoscopic gastrostomy) insertion using a pre-existing abdominal surgical incision in an obese patient, 73 endoscopic papillectomy, 74 endoscopic myotomy. 75 Choi et al reported 5 colonoscopies made by situs inversus patients between 2001 and 2006.…”

Section: Gastro-and Colonoscopymentioning

confidence: 99%

“…99 The camera can be introduced through the umbilical port, the other port positions can be then placed according to the exact position of the appendix and the technique is to be modified to suit each individual patient. 74…”

Section: Appendectomymentioning

confidence: 99%

Situs Inversus Totalis: A Clinical Review

Eitler¹,

Bibok²,

Telkes³

2022

IJGM

100

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Situs inversus totalis is a rare congenital abnormality characterized by a mirror-image transposition of both the abdominal and the thoracic organs. While this anomaly is known since the ancient times, practicing doctors do not have much experience with it. Laterality is established early in development, and any failure in that process might lead to a wide variety of disorders which may be partial or complete. Situs solitus describes the normal anatomy, situs inversus is the complete reversal, and situs ambiguous is used for any other abnormality of left-right development. Sidedness is regulated by genes: over 100 genes have been linked to laterality defects. Frequency of situs inversus is 1:10,000 and is more frequent in males: 1.5:1. Advanced imaging modalities can be used to assess fine anatomical details, which play a crucial role in these cases to plan radiologic or surgical interventions. Percutaneous biliary procedures, portal vein embolization are really challenging procedures in SIT patients due to the mirror effect. As most surgeons are right-handed, SIT operations can cause difficulties: handling the instruments with their left hand or the pedals with their left foot can be uncomfortable Organ, especially liver transplantation represents an extraordinary surgical challenge. Solutions to overcome the anatomic differences include the use of segment or reduced size graft with rotation, modified piggy-back technique, side to-side caval anastomosis, and vascular conduit. Because of its rarity and special nature, surgical patients with situs inversus may require more flexibility and creativity from the surgical team.

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Successful endoscopic papillectomy in a patient with situs inversus

Cited by 3 publications

References 4 publications

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

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

Successful endoscopic retrograde cholangiopancreatography using pancreatic guidewire placement for biliary cannulation in a patient with situs inversus and Billroth‐I gastrectomy (with video)

Situs Inversus Totalis: A Clinical Review

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