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Biliary ascariasis after Roux-en-Y hepaticojejunostomy
L H Braga1, E S Tatsuo, J T Guimarães
1Department of Surgery, Faculty of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Journal of Pediatric Surgery
|September 22, 2000
Summary
Biliary ascariasis can occur after surgery for choledochal cysts. Ultrasonography aids diagnosis, and surgery may be needed if other treatments fail, especially in endemic areas.
Area of Science:
- Hepatobiliary surgery
- Parasitic infections
- Pediatric surgery
Background:
- Choledochal cysts are congenital dilations of the bile ducts.
- Roux-en-Y hepaticojejunostomy is a common surgical reconstruction technique.
- Ascariasis is a parasitic infection caused by roundworms.
Observation:
- A 6-year-old girl developed biliary ascariasis post-Roux-en-Y hepaticojejunostomy for a choledochal cyst.
- Ultrasonography provided a precise diagnosis of the condition.
- Clinical and endoscopic treatments were insufficient.
Findings:
- Surgical intervention was necessary for the biliary ascariasis.
- Biliary ascariasis is a potential complication following biliary-digestive tract reconstruction.
- The case highlights the importance of considering parasitic infections in post-operative cholangitis.
Implications:
- In endemic regions, biliary ascariasis should be included in the differential diagnosis for cholangitis after hepaticojejunostomy.
- Early and accurate diagnosis via ultrasonography is crucial.
- Management may require a multidisciplinary approach involving surgeons and infectious disease specialists.