TECHNICAL CONSIDERATION WITH ENDOSCOPY IN SITUS INVERSUS TOTALIS
Jason Nasser*, Muhammad Talal Sarmini, Catherine F. Vozzo, Mohannad Abou Saleh, Prabhleen Chahal
Internal Medicine, Cleveland Clinic Foundation, Avon Lake, OH
A 64-year-old female with known history of situs inversus presented jaundiced skin and diffuse pruritis. CT abdomen revealed a 3.8 x 1.9 cm heterogenous partially enhancing pancreatic mass, moderate intrahepatic biliary dilation with a non-distended CBD. ERCP showed stenosed common bile duct. A temporary stent was placed and cytology was positive for cholangiocarcinoma.
It is essential for gastroenterologists in general and advanced endoscopists specifically to be familiar with SIT anatomy and the challenges associated with it which includes interoperating symptoms, imaging studies and performing diagnostic or therapeutic endoscopy.
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