Endoscopic Retrograde Cholangiopancreatography in a Patient with Situs Inversus Totalis

Endoscopic retrograde cholangiopancreatography (ERCP) technique is a widely accepted procedure in treating obstructing diseases of the common bile duct. The equipment and instruments of which are designed for patients with common anatomic features. The variations of anatomic landmarks make the procedure more demanding. A rare congenital situation, situs inversus totalis (SIT), is the mirror image placement of abdominal and thoracic viscera. The vice versa placement of intra-abdominal organs requires the technical change of standard maneuvers and setup when a need of the ERCP procedure arises. This case report emphasizes these changes in the ERCP procedure of a patient with common bile duct stone and SIT.