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Therapeutic ERCP in patient with situs inversus totalis and ampullary diverticulum.

Authors
  • Kamani, Lubna1
  • Kumar, Raj1
  • Mahmood, Shahid1
  • Jafri, Sana1
  • Siddiqui, Faisal2
  • 1 Department of Gastroenterology, Liaquat National Hospital, Karachi.
  • 2 Department of General Surgery, Liaquat National Hospital, Karachi.
Type
Published Article
Journal
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
Publication Date
May 01, 2014
Volume
24
Issue
5
Pages
365–366
Identifiers
DOI: 04.2014/JCPSP.365366
PMID: 24848398
Source
Medline
License
Unknown

Abstract

Situs Inversus Totalis (SIT) is a rare entity with complete transposition of all viscera, making endoscopic and surgical procedures challenging and complicated. We describe a rare case of a 55 years old man with SIT and ampullary diverticulum presenting with cholangitis and deranged liver function tests due to common bile duct stones. Therapeutic Endoscopic Retrograde Cholangiopancreatography (ERCP) was planned to relieve biliary obstruction and removal of stones. Procedure was started after informed consent in usual left semi-prone position but rotation of scope to 180 degrees and shortening under fluoroscopic guidance was done to attain and maintain desirable ampullary position and cannulation was done with standard sphincterotome followed by sphincterotomy and sphincteroplasty. ERCP was performed successfully despite difficulties of dual pathology and the patient made uneventful recovery.

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