A Case of Bile Duct Carcinoma with Situs Inversus Totalis

Shinichi Maeda, Yoshito Ogura, Keiichirou Uchikura, Kousei Maemura¹⁾, Hiroyuki Shinchi²⁾, Sonshin Takao³⁾ and Shoji Natsugoe²⁾

Department of Surgery, National Hospital Organization MinamiKyusyu Hospital
Saiseikai Sendai Hospital¹⁾
Department of Surgical Oncology and Digestive Surgery, Kagoshima University Faculty of Medicine²⁾
Frontier Science Research Center, Kagoshima University Faculty of Medicine³⁾

We report a case of bile duct carcinoma with situs inversus totalis. A 75-year-old woman referred for obstructive icterus was found in abdominal computed tomography (CT) to have situs inversus totalis and bile duct obstruction due to a tumor. Percutaneous transhepatic cholangiography (PTC) showed an elevated tumor from the upper to the middle of the common bile duct. In surgery based on a diagnosis of bile duct carcinoma, we found a soft tumor of the common bile duct, resecting the bile duct with lymphadenectomy and reconstruction with an extrahepatic bile duct jejunostomy. The definitive diagnosis was early bile duct cancer, papillary with superficial spreading, and moderately differentiated adenocarcinoma. This is only the seventh case of bile duct carcinoma with situs inversus, to our knowledge, reported in the Japanese literature.

Key words
situs inversus totalis, bile duct carcinoma

Reprint requests
Shinichi Maeda Department of Surgery, National Hospital Organization MinamiKyusyu Hospital
1882 Kida, Kajiki-cho, 899-5293 JAPAN

Accepted
April 22, 2009

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