PMC4282852_01
Abdominal computed tomography scan (coronal view) showing situs inversus totalis and a bile duct stone (white arrow) and multiple gall bladder stones.
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An abdominal computed tomography scan revealed transposition of the visceral organs from the right to left side and a stone in the dilated common bile duct (CBD) (Fig. 1).
A cap-fitted forward-viewing endoscope demonstrating Billroth-II gastrectomy with gastrojejunostomy status.
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Endoscopic retrograde cholangiopancreatography (ERCP) was performed with a cap-assisted forward-viewing endoscope (Olympus, Tokyo, Japan) in patient with gastrojejunostomy (Fig. 2).
A cholangiogram of endoscopic retrograde cholangiopancreatography demonstrating transposition of pancreatic duct oriented to the right side and gallbladder and dilated common bile duct with a movable filling defect to the left side.
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A cholangiogram revealed transposition of the pancreatic duct oriented to the right side and the gallbladder and dilated CBD with a floating stone to the left side (Fig. 3).
A cap-fitted forward-viewing endoscope showing guide wire placed in orifice of bile duct at 7 o'clock position.
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After biliary cannulation using catheter with a straight end at the 7 o'clock direction of major papilla, a guidewire was placed across the ampullary orifice (Fig. 4).
A complete stone removal using endoscopic papillary balloon dilatation.
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Following endoscopic papillary balloon dilatation (EPBD) using a controlled radial expansion balloon (10 mm; Boston Scientific Microvasive, Cork, Ireland), a CBD stone was successfully retrieved using a basket (Fig. 5).