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Reporte de caso
Medwave 2017 Jul;17(6):e7002 doi: 10.5867/medwave.2017.06.7002
Tratamiento quirúrgico de coledocolitiasis en situs inversus totalis: reporte de caso y revisión de la literatura
Surgical treatment of choledocholithiasis in a patient with situs inversus totalis: a case report and literature review
Jerson Francisco Morales-Rodríguez, Estefania Corina Cotillo, Oscar Moreno-Loaiza
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Palabras clave: coledocolitiasis, situs Inversus, colelitiasis

Abstract

Situs inversus totalis (SIT) is a rare condition, in which there is transposition of the thoraco-abdominal organs. This situation leads to diagnostic and therapeutic difficulties in patients with acute surgical abdomen. The objective of this report is to present the case of a patient who presented with colonic pain in the epigastrium and left hypochondrium, in which the diagnosis of SIT, cholelithiasis and choledocholithiasis was reached after the respective imaging studies. Once the diagnosis was made, treatment was performed through retrograde endoscopic cholangiopancreatography (ERCP) and subsequent surgical exploration of bile ducts. Both procedures were failed due to technical difficulties generated by the patient's condition. In conclusion, in spite of the report of successful cases in the literature of ERCP and surgical treatment of the biliary tract in SIT, there may be situations that do not allow a successful approach, so meticulous surgical planning and the use of support methods are necessary In the management of these patients


 

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Situs inversus totalis (SIT) is a rare condition, in which there is transposition of the thoraco-abdominal organs. This situation leads to diagnostic and therapeutic difficulties in patients with acute surgical abdomen. The objective of this report is to present the case of a patient who presented with colonic pain in the epigastrium and left hypochondrium, in which the diagnosis of SIT, cholelithiasis and choledocholithiasis was reached after the respective imaging studies. Once the diagnosis was made, treatment was performed through retrograde endoscopic cholangiopancreatography (ERCP) and subsequent surgical exploration of bile ducts. Both procedures were failed due to technical difficulties generated by the patient's condition. In conclusion, in spite of the report of successful cases in the literature of ERCP and surgical treatment of the biliary tract in SIT, there may be situations that do not allow a successful approach, so meticulous surgical planning and the use of support methods are necessary In the management of these patients

Autores: Jerson Francisco Morales-Rodríguez[1], Estefania Corina Cotillo[2], Oscar Moreno-Loaiza[3]

Filiación:
[1] Departamento de Cirugía, Hospital Carlos Alberto Seguín Escobedo, Arequipa, Perú
[2] Facultad de medicina, Universidad Andina Néstor Cáceres Velásquez, Puno, Perú
[3] Facultad de Medicina, Universidad Nacional San Agustín, Arequipa, Perú

E-mail: oscarml5@hotmail.com

Correspondencia a:
[1] Urbanización Villa Gloria 4 f-7
Arequipa
Perú

Citación: Morales-Rodríguez JF, Corina Cotillo E, Moreno-Loaiza O. Surgical treatment of choledocholithiasis in a patient with situs inversus totalis: a case report and literature review. Medwave 2017 Jul;17(6):e7002 doi: 10.5867/medwave.2017.06.7002

Fecha de envío: 24/4/2017

Fecha de aceptación: 8/7/2017

Fecha de publicación: 26/7/2017

Origen: no solicitado

Tipo de revisión: con revisión por tres pares revisores externos, a doble ciego

Ficha PubMed

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  1. Navarro V, Oshiro H, Peña B, Moquillaza Pineda F. [Situs inversus totalis]. Rev Gastroenterol Peru. 2013 Oct-Dec;33(4):345-7. | PubMed |
  2. Machado NO, Chopra P. Laparoscopic cholecystectomy in a patient with situs inversus totalis: feasibility and technical difficulties. JSLS. 2006 Jul-Sep;10(3):386-91. | PubMed |
  3. Sena R, Weiss M, Abreu A, Costa L, Peixoto R, Gomes C, et al. Laparoscopic Cholecystectomy in Patient with Situs Inversus Totalis: Diagnostic and Treatment Pitfalls. Arch Clin Exp Surg. 2016;5(2): 124-127. | CrossRef |
  4. Hu Y, Zeng H, Pan XL, Lv NH, Liu ZJ, Hu Y. Therapeutic endoscopic retrograde cholangiopancreatography in a patient with situs inversus viscerum. World J Gastroenterol. 2015 May 14;21(18):5744-8. | CrossRef | PubMed |
  5. Castro DJ, De Faria A. Case study of a sphincterotomy to remove stones from the common bile duct cholelithiasis biliary in a patient with total situs inversus. Rev Colomb Gastroenterol. 2013;28(2):146-8. | Link |
  6. Melchor-González JM, Pérez-García R, Torres-Vista M, Rodríguez-Brambila VR. Situs inversus. Reporte de dos casos. Cir Ciruj. 2000;68(2):72-75. | Link |
  7. Çoban Ş, Yüksel I, Küçükazman M, Başar Ö. Successful ERCP in a patient with situs inversus. Endoscopy. 2014;46 Suppl 1 UCTN:E222. | CrossRef | PubMed |
  8. Vega CGR, Salazar BMA, Calderón JR, Preciado BCY, Heredia JNM, Gandarilla JS. Litiasis vesicular y situs inversus totalis resueltos por cirugía endoscópica con asistencia acuscópica. Rev Mex Cir Endoscop. 2003;4(3):153-161. | Link |
  9. Reddy A, Paramasivam S, Alexander N, Abhilash, Ravisankar V, Thillai M. Management of a patient with situs inversus totalis with acute cholecystitis and common bile duct stones: A case report. Int J Surg Case Rep. 2014;5(11):821-3. | CrossRef | PubMed |
  10. Salama IA, Abdullah MH, Houseni M. Laparoscopic cholecystectomy in situs inversus totalis: Feasibility and review of literature. Int J Surg Case Rep. 2013;4(8):711-5. | CrossRef | PubMed |
Navarro V, Oshiro H, Peña B, Moquillaza Pineda F. [Situs inversus totalis]. Rev Gastroenterol Peru. 2013 Oct-Dec;33(4):345-7. | PubMed |

Machado NO, Chopra P. Laparoscopic cholecystectomy in a patient with situs inversus totalis: feasibility and technical difficulties. JSLS. 2006 Jul-Sep;10(3):386-91. | PubMed |

Sena R, Weiss M, Abreu A, Costa L, Peixoto R, Gomes C, et al. Laparoscopic Cholecystectomy in Patient with Situs Inversus Totalis: Diagnostic and Treatment Pitfalls. Arch Clin Exp Surg. 2016;5(2): 124-127. | CrossRef |

Hu Y, Zeng H, Pan XL, Lv NH, Liu ZJ, Hu Y. Therapeutic endoscopic retrograde cholangiopancreatography in a patient with situs inversus viscerum. World J Gastroenterol. 2015 May 14;21(18):5744-8. | CrossRef | PubMed |

Castro DJ, De Faria A. Case study of a sphincterotomy to remove stones from the common bile duct cholelithiasis biliary in a patient with total situs inversus. Rev Colomb Gastroenterol. 2013;28(2):146-8. | Link |

Melchor-González JM, Pérez-García R, Torres-Vista M, Rodríguez-Brambila VR. Situs inversus. Reporte de dos casos. Cir Ciruj. 2000;68(2):72-75. | Link |

Çoban Ş, Yüksel I, Küçükazman M, Başar Ö. Successful ERCP in a patient with situs inversus. Endoscopy. 2014;46 Suppl 1 UCTN:E222. | CrossRef | PubMed |

Vega CGR, Salazar BMA, Calderón JR, Preciado BCY, Heredia JNM, Gandarilla JS. Litiasis vesicular y situs inversus totalis resueltos por cirugía endoscópica con asistencia acuscópica. Rev Mex Cir Endoscop. 2003;4(3):153-161. | Link |

Reddy A, Paramasivam S, Alexander N, Abhilash, Ravisankar V, Thillai M. Management of a patient with situs inversus totalis with acute cholecystitis and common bile duct stones: A case report. Int J Surg Case Rep. 2014;5(11):821-3. | CrossRef | PubMed |

Salama IA, Abdullah MH, Houseni M. Laparoscopic cholecystectomy in situs inversus totalis: Feasibility and review of literature. Int J Surg Case Rep. 2013;4(8):711-5. | CrossRef | PubMed |