RESUMO
An 85-year-old female with situs inversus totalis was admitted due to obstructive jaundice, secondary to multiple choledocholithiasis and distal biliary stenosis due to adenocarcinoma of the head of the pancreas, with duodenal infiltration and metastatic liver disease. An endoscopic retrograde cholangiopancreatography (ERCP) was attempted in the supine position but bile duct cannulation was not possible due to duodenal infiltration. Finally, a palliative biliary stent was placed percutaneously, with resolution of the jaundice.
Assuntos
Coledocolitíase , Icterícia Obstrutiva , Situs Inversus , Idoso de 80 Anos ou mais , Colangiopancreatografia Retrógrada Endoscópica , Coledocolitíase/complicações , Coledocolitíase/diagnóstico por imagem , Coledocolitíase/cirurgia , Duodeno , Feminino , Humanos , Icterícia Obstrutiva/diagnóstico por imagem , Icterícia Obstrutiva/etiologia , Situs Inversus/complicações , Situs Inversus/diagnóstico por imagemRESUMO
We present the case of a 55-year-old female with no history of interest and asymptomatic, who was admitted to perform studies due to findings of an abdominal ultrasound. A dilated left intrahepatic bile duct and a segment of the common hepatic duct, the proximal bile duct, was identified with irregular thickening of the wall, with an increased caliber (12 mm). A cystic lesion of 6 x 5.5 x 8 cm was also identified in the left liver lobe, with multiple septa. Computed tomography (CT) and magnetic resonance imaging (MRI) showed overlapping findings. Endoscopic retrograde cholangiopancreatography (ERCP) identified a filling defect in the common hepatic duct-left intrahepatic duct, which was not pulled with a Fogarty balloon, although it passed through it.