Gallbladder agenesis with a primary choledochal stone in a patient with situs inversus totalis
نویسندگان
چکیده
PATIENT Female, 68 FINAL DIAGNOSIS: Gallbladder agenesis with situs inversus totalis Symptoms: Epigastric pain • jaundice MEDICATION - Clinical Procedure: - Specialty: Surgery. OBJECTIVE Rare disease. BACKGROUND Situs inversus totalis is an inherited condition characterized by the mirror-image transposition of thoracic and abdominal organs. Gallbladder agenesis, which has normal bile ducts, is a rare congenital condition that occurs in 13 to 65 people out of 100 000. A common bile duct (CBD) stone or choledocholithiasis in patients with gallbladder agenesis is even rarer. CASE REPORT We report the case of a 68-year-old woman who presented with epigastric pain and jaundice. She was not known to have situs inversus totalis. Abdominal ultrasound showed a large stone in the CBD, which could not be extracted by endoscopic retrograde cholangiopancreatography (ERCP), necessitating exploration. The gall-bladder and cystic duct were found to be absent. Incisional exploration of the CBD was performed, and a large stone was removed. A choledochoscope was used to identify the remnants and exclude the presence of ectopic gallbladder, and a T-tube was placed into the CBD. CONCLUSIONS Gallbladder agenesis in a patient with situs inversus totalis is extremely rare, with no single reported case identified in the literature. In addition, our case showed a rare complication of ERCP - a failure to extract the CBD stone - and illustrates a way to overcome this complication.
منابع مشابه
Choledochal cyst in situs inversus totalis: Hitherto unreported association
Situs inversus totalis is a rare autosomal recessive disorder characterized by transposition of the intra-abdominal as well as the intrathoracic viscera. We present the case of a 45-year-old Pakistani lady who had choledochal cyst with cholelithiasis in tandem with situs inversus totalis. We were faced with dilemmas both diagnostic and management during the course of her care. We share our expe...
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