Nuretdin SUNA, Selçuk DİŞİBEYAZ, Ufuk Barış KUZU, Aydın Şeref KÖKSAL, Erkin ÖZTAŞ, Serkan TORUN, Erkan PARLAK

Situs inversus totalisli bir hastada terapötik endoskopik retrograd kolanjiyopankreatografi

Situs inversus totalis, torasik ve abdominal organların ayna hayali şeklinde yer değitirmesi ile karakterize nadir konjenital bir anomalidir. Situs inversus totalisli hastalarda safra kanalı ekseninin değişimi nedeniyle sıradan bir endoskop ile teröpatik endoskopik retrograt kolanjiopankreatografi endoskopik retrograd olanjiyopankreatografi yapmak çok daha zor olmaktadır. Bu yazıda, situs inversus totalisli bir hastada endoskopik retrograd kolanjiyopankreatografi işlemi olağan poziyonunda başarsız olmasına karşın sağ lateral dekübitis pozisyonda başarılı endoskopik retrograd kolanjiyopankreatografi işlemi yapılan olguyu sunuyoruz.

Anahtar Kelimeler:

Situs inversus totalis, koledok taşı, ERKP, çoklu metalik stent

Therapeutic endoscopic retrograde cholangiopancreatography in a patient with situs inversus totalis

Situs inversus totalis is a rare congenital anomaly characterized by transposition of the abdominal and thoracic organs in a mirror image reversal. Therapeutic endoscopic retrograde collangiopancreatography with a regular endoscope is much more difficult due to the variation of the bile duct axis. In this article, we present a case of a successful endoscopic retrograde collangiopancreatography in a situs inversus totalis patient in the right lateral decubitus position rather than the regular position, in which the endoscopicretrograde collangiopancreatography procedure was unsuccessful.

Keywords:

Situs inversus totalis, endoscopic retrograde collangiopancreatography, bile duct stone,

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1- Lee SE, Kim HY, Jung SE, et al. Situs anomalies and gastrointestinal abnormalities. J Pediatr Surg 2006;41:1237-42.
2- Uemura S, Maeda H, Munekage M, et al. Hepatic resection for metastatic colon cancer in patients with situs inversus totalis complicated by multiple anomalies of the hepatobiliary system: the first case report. J Gastrointest Surg 2009;13:1724-7.
3- Blegen HM. Surgery in situs inversus. Ann Surg 1949;129:244-59.
4- Sands SS, Taylor JF. Prescreen evaluation of situs inversus patients. Int Surg 2001;86:254-8.
5- McDermott JP, Caushaj PF. ERCP and laparoscopic cholecystectomy for cholangitis in a 66-year-old male with situs inversus. Surg Endosc 1994;8:1227-9.
6- Venu RP, Geenen JE, Hogan WJ et al. ERCP and endoscopic sphincterotomy in patients with situs inversus. Gastrointest Endosc 1985;31:338-40.
7- Hu B, Wang CH, Chen P, et al. Acute cholangiopancreatic diseases with situs inversus totalis treated with endoscopic sphincterotomy: Report of two cases. J Dig Dis 2009;10:71-3.
8- Benhammane H, Kharmoum S, Terraz S. Common bile duct adenocarcinoma in a patient with situs inversus totalis: report of a rare case. BMC Res Notes 2012;5:681.
9- Fiocca F, Donatelli G, Ceci V, et al. ERCP in total situs viscerum inversus. Case Rep Gastroenterol 2008;2:116-20.
10- García-Fernández FJ, Infantes JM, Torres Y, et al. ERCP in complete situs inversus viscerum using a “mirror image” technique. Endoscopy 2010;42(Suppl 2):E316-7.
11- de la Serna-Higuera C, Perez-Miranda M, Flores-Cruz G, et al. Endoscopic retrograde cholangiopancreatography in situs inversus partialis. Endoscopy 2010;42(Suppl 2):E98.
12- Lipschutz JH, Canal DF, Hawes RH, et al. Laparoscopic cholecystectomy and ERCP with sphincterotomy in an elderly patient with situs inversus. Am J Gastroenterol 1992;87:218-20.
13- Nordback I, Airo I. ERCP and endoscopic papillotomy in complete abdominal situs inversus. Gastrointest Endosc 1988;34:150.