Scholarlink

<p>Situs inversus totalis (SIT) is a rare congenital condition characterized by mirror-image arrangement of thoracoabdominal organs, occurring in approximately 1 in 4,000–8,000 individuals. Choledochal cysts (CC) are also uncommon congenital anomalies of the biliary tree, with much higher prevalence in Asian populations. The coexistence of SIT and CC, particularly in children, is extremely rare, posing diagnostic and surgical challenges. We report a 15-month-old toddler who presented with intermittent abdominal discomfort, occasional non-bilious vomiting, and history of fever, without jaundice. Clinical examination revealed dextrocardia. Ultrasonography and magnetic resonance cholangiopancreatography (MRCP) confirmed SIT with a Type I choledochal cyst. No intrahepatic biliary dilatation was noted. Intervention: Laparoscopic excision of the choledochal cyst with hepaticoduodenostomy was performed using mirrored port positioning to account for reversed anatomy. The cyst and gallbladder were excised, the distal common bile duct was ligated, and an interrupted hepaticoduodenostomy was done with 4 − 0 Vicryl. The postoperative period was uneventful. At 30 months follow-up, patient remained asymptomatic with appropriate weight gain and normal development. Postoperative liver function tests were within normal limits. Conclusion: Laparoscopic choledochal cyst excision with hepaticoduodenostomy is feasible and safe in pediatric patients with SIT, though it requires meticulous preoperative imaging, careful operating room setup, and adaptation to mirror-image anatomy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Laparoscopic Hepaticoduodenostomy for Choledochal Cyst in a Toddler with Situs Inversus Totalis : a Case Report

  • 期刊论文

  • 发表日期：

    2026年6月30日

查看全文
  • Navyasree Venkata,
  • K. V. Sathyanarayana

摘要

Situs inversus totalis (SIT) is a rare congenital condition characterized by mirror-image arrangement of thoracoabdominal organs, occurring in approximately 1 in 4,000–8,000 individuals. Choledochal cysts (CC) are also uncommon congenital anomalies of the biliary tree, with much higher prevalence in Asian populations. The coexistence of SIT and CC, particularly in children, is extremely rare, posing diagnostic and surgical challenges. We report a 15-month-old toddler who presented with intermittent abdominal discomfort, occasional non-bilious vomiting, and history of fever, without jaundice. Clinical examination revealed dextrocardia. Ultrasonography and magnetic resonance cholangiopancreatography (MRCP) confirmed SIT with a Type I choledochal cyst. No intrahepatic biliary dilatation was noted. Intervention: Laparoscopic excision of the choledochal cyst with hepaticoduodenostomy was performed using mirrored port positioning to account for reversed anatomy. The cyst and gallbladder were excised, the distal common bile duct was ligated, and an interrupted hepaticoduodenostomy was done with 4 − 0 Vicryl. The postoperative period was uneventful. At 30 months follow-up, patient remained asymptomatic with appropriate weight gain and normal development. Postoperative liver function tests were within normal limits. Conclusion: Laparoscopic choledochal cyst excision with hepaticoduodenostomy is feasible and safe in pediatric patients with SIT, though it requires meticulous preoperative imaging, careful operating room setup, and adaptation to mirror-image anatomy.