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Sonographic findings in gallbladder ascariasis.

M S Khuroo1, S A Zargar, G N Yattoo

  • 1Department of Gastroenterology, Institute of Medical Sciences, Srinagar, Kashmir, India.

Journal of Clinical Ultrasound : JCU
|November 1, 1992
PubMed
Summary

Gallbladder invasion by adult roundworm (Ascaris lumbricoides) is rare. Real-time sonography effectively diagnoses this condition and monitors worm expulsion, offering a superior approach to endoscopic retrograde cholangiography.

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Area of Science:

  • Hepatobiliary Medicine
  • Parasitology
  • Medical Imaging

Background:

  • Hepatobiliary ascariasis, caused by Ascaris lumbricoides, can rarely involve the gallbladder.
  • This specific presentation was observed in 14 (2.1%) of 665 hepatobiliary ascariasis cases.

Purpose of the Study:

  • To evaluate the diagnostic utility of sonography and endoscopic retrograde cholangiography (ERC) for gallbladder ascariasis.
  • To identify factors facilitating gallbladder invasion by Ascaris lumbricoides.
  • To assess the role of serial sonography in monitoring worm expulsion.

Main Methods:

  • Retrospective analysis of 14 cases of Ascaris lumbricoides gallbladder invasion.
  • Review of sonographic and ERC findings in affected patients.
  • Correlation of imaging findings with clinical outcomes.

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Main Results:

  • Sonography suggested the diagnosis in all 13 cases where it was performed.
  • ERC provided a diagnosis in 5 of 11 cases.
  • Characteristic sonographic findings included echogenic, mobile structures within the gallbladder.
  • Pregnancy and anomalous cystic duct origin were identified as facilitating factors.
  • Serial sonograms accurately predicted spontaneous worm exit.

Conclusions:

  • Real-time sonography is a simple, rapid, and effective tool for diagnosing and following gallbladder ascariasis.
  • Endoscopic retrograde cholangiography has limited diagnostic value for this condition.
  • Sonography aids in monitoring spontaneous expulsion of Ascaris lumbricoides from the gallbladder.