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Hepatolithiasis with biliary ascariasis--a case report.

K S Pilankar1, A D Amarapurkar, R M Joshi

  • 1Department of Pathology, B Y L Nair Charitable Hospital and T N Medical College, Mumbai, India. kirtikumarp@yahoo.com

BMC Gastroenterology
|December 23, 2003
PubMed
Summary

Biliary ascariasis, a parasitic worm infection, can cause liver stones (hepatolithiasis) and liver abscesses. Early diagnosis and treatment, including surgery and antihelminthic therapy, are crucial for recovery.

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Area of Science:

  • Hepatobiliary Surgery
  • Infectious Diseases
  • Gastroenterology

Background:

  • Hepatolithiasis (bile duct stones) is often linked to biliary ascariasis (liver fluke infection).
  • This case highlights the potential of parasitic infections as etiological factors in hepatolithiasis.

Observation:

  • A young adult female presented with recurrent cholangitis, epigastric pain, and vomiting.
  • Endoscopic retrograde cholangiopancreatography (ERCP) revealed intrahepatic calculi and a liver abscess.
  • Histological examination post-partial hepatectomy confirmed biliary ascariasis.

Findings:

  • Surgical resection of the affected liver lobe combined with antihelminthic therapy led to a successful outcome.
  • The patient experienced an uneventful recovery and remained disease-free for two years post-surgery.

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Implications:

  • Biliary ascariasis should be considered in the differential diagnosis of hepatolithiasis and liver abscesses, especially in endemic regions.
  • Integrated treatment approaches involving surgery and antiparasitic medication are effective for managing complex hepatolithiasis cases.