Modified ERCP Technique for Choledocholithiasis in Situs Inversus Totalis

Situs inversus totalis (SIT) is a rare congenital condition characterized by a complete mirror-image reversal of the thoracic and abdominal organs. Although usually asymptomatic, SIT poses significant challenges during diagnostic and therapeutic procedures due to reversed anatomy. Endoscopic retrograde cholangiopancreatography (ERCP) is the standard treatment of biliary and pancreatic ductal diseases, yet it becomes technically demanding in patients with SIT. We report a case of choledocholithiasis in a patient with SIT successfully managed with ERCP, and briefly review relevant procedural considerations.