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内镜袖状胃成形术中发现内脏反位:病例报告。

Finding of situs inversus in endoscopic sleeve gastroplasty: Case report.

作者信息

Quiroz Guadarrama C D, Girón F, Rojano M, Lopez-Nava G, Zundel N

机构信息

Clínica del Noroeste, Hermosillo, Mexico; IFSO, USA.

Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia; IFSO, USA; Fundación Santa Fe de Bogotá, Colombia.

出版信息

Int J Surg Case Rep. 2025 Jan;126:110727. doi: 10.1016/j.ijscr.2024.110727. Epub 2024 Dec 9.

Abstract

INTRODUCTION AND IMPORTANCE

Situs inversus is an anatomical rare condition in which visceral organs are not located in its normal position, with a reversal anatomical orientation.

CASE PRESENTATION

We present a case of an 27-year-old male with a Body Mass Index (BMI) of 36.02 Kg/m2, who was programed for a Endoscopic Sleeve Gastroplasty (ESG), in which Situs inversus was documented.

CLINICAL DISCUSSION

Situs inversus is an uncommon anatomical condition that complicates identifying surgical landmarks and performing procedures like ESG. Preoperative imaging, such as abdominal ultrasound or computed tomography, is critical for confirming the diagnosis and planning the intervention. In this case, ESG was successfully executed using standard techniques, emphasizing the importance of expertise and careful planning. The reversed anatomy required adjustments in endoscopic navigation but did not necessitate major deviations from established protocols. This case highlights that, under the care of experienced endoscopists, ESG remains a safe and effective option for patients with situs inversus.

CONCLUSION

Situs inversus is rare anatomical variation that can represent a challenge in bariatric endoscopic procedures such as ESG. Nevertheless, ESG can be safely performed under an experienced endoscopic bariatric surgeon.

摘要

引言与重要性

内脏反位是一种解剖学上罕见的情况,即内脏器官未处于正常位置,解剖方向发生反转。

病例介绍

我们报告一例27岁男性,体重指数(BMI)为36.02 Kg/m²,计划接受内镜袖状胃成形术(ESG),术中发现存在内脏反位。

临床讨论

内脏反位是一种罕见的解剖学情况,会使识别手术标志和进行如ESG这样的手术变得复杂。术前成像,如腹部超声或计算机断层扫描,对于确诊和规划干预措施至关重要。在本病例中,采用标准技术成功实施了ESG,强调了专业知识和精心规划的重要性。解剖结构的反转需要在内镜导航中进行调整,但无需大幅偏离既定方案。该病例表明,在经验丰富的内镜医师的护理下,ESG对于内脏反位患者仍然是一种安全有效的选择。

结论

内脏反位是一种罕见的解剖变异,在诸如ESG等减重内镜手术中可能构成挑战。然而,在经验丰富的内镜减重外科医生的操作下,ESG可以安全地进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1852/11750274/2195bf65a90f/gr1.jpg

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