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Ascaris-mimicking common bile duct stone: A case report
Seo-Youn Choi1, Ha Eun Jo2, Yun Nah Lee3
1Radiology, Soonchunhyang University Hospital, Bucheon, Bucheon 14584, South Korea. sychoi@schmc.ac.kr.
World Journal of Clinical Cases
|October 21, 2020
Summary
A rare case highlights how a common bile duct (CBD) stone can mimic Ascaris infection. Imaging findings initially suggested parasitic infection, but endoscopic extraction revealed a CBD stone.
Area of Science:
- Gastroenterology
- Radiology
- Parasitology
Background:
- Differentiating common bile duct (CBD) stones from Ascaris infection is typically straightforward due to distinct clinical and imaging features.
- Computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) usually show unique findings for each condition.
Observation:
- A 72-year-old male presented with elevated liver enzymes and imaging findings suggestive of Ascaris infection.
- CT revealed a hyper-attenuated lesion in the CBD; MRCP and endoscopic retrograde cholangiopancreatography (ERCP) showed a linear filling defect.
Findings:
- Endoscopic ultrasound (EUS) demonstrated elongated echogenic material with a central hypoechogenic area, further supporting the suspicion of Ascaris.
- Despite initial imaging interpretations, endoscopic extraction revealed the lesion to be a dark-brown-colored CBD stone, not a parasitic infection.
Implications:
- This case underscores the importance of considering alternative diagnoses even when imaging findings appear characteristic of a specific condition.
- A review of literature comparing imaging features of CBD stones and ascariasis is warranted to improve diagnostic accuracy in rare overlapping presentations.
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