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Related Experiment Videos

Biliary ascariasis: percutaneous transhepatic management.

Nevzat Ozcan1, Nuri Erdogan, Can Kucuk

  • 1Department of Radiology, Erciyes University Faculty of Medicine, 38039-Kayseri, Turkey. nevzatcan@yahoo.com

Journal of Vascular and Interventional Radiology : JVIR
|March 13, 2003
PubMed
Summary

A novel percutaneous transhepatic approach successfully removed roundworms from bile ducts when endoscopy failed. This minimally invasive technique offers a viable alternative for treating biliary ascariasis complications.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Parasitology

Background:

  • Biliary ascariasis, a parasitic infection of the bile ducts by Ascaris lumbricoides, can cause significant complications post-cholecystectomy.
  • Persistent elevation of bilirubin levels and filling defects on T-tube cholangiography indicated roundworm reinfestation in a post-operative patient.

Observation:

  • The patient, who had undergone cholecystectomy and T-tube drainage for biliary ascariasis, presented with increasing postoperative bilirubin levels.
  • T-tube cholangiography revealed multiple filling defects in the bile ducts, strongly suggesting residual or re-infesting roundworms.

Findings:

  • Endoscopic retrograde cholangiopancreatography (ERCP) was not feasible due to patient intolerance.
  • A percutaneous transhepatic approach was successfully employed, involving balloon dilatation of the ampulla of Vater.

Related Experiment Videos

  • Roundworms were advanced into the duodenum using an embolectomy balloon, with the procedure being successful and without major complications.
  • Implications:

    • This case demonstrates the feasibility of a percutaneous transhepatic approach for managing biliary ascariasis when endoscopic extraction is not possible.
    • This minimally invasive technique provides a valuable alternative to repeat surgery for complex cases of roundworm infestation in the biliary system.
    • The findings highlight the importance of considering less invasive interventional radiology techniques in managing parasitic biliary tract disease.