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Endoscopic management of biliary ascariasis
1Department of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong.
Gastrointestinal Endoscopy
|July 1, 1988
Summary
Ascaris lumbricoides worms migrating to the biliary tree can cause cholangitis and pancreatitis. Endoscopic extraction from the biliary tree was successful, but pancreatic extraction was difficult, necessitating anthelmintic therapy.
Area of Science:
- Gastroenterology and Parasitology
- Hepatobiliary and Pancreatic Diseases
Background:
- Ascariasis, caused by Ascaris lumbricoides, can lead to serious complications.
- Worm migration into the biliary tree is a known, albeit uncommon, complication.
- Biliary ascariasis can manifest as cholangitis and pancreatitis.
Purpose of the Study:
- To describe the endoscopic management of biliary and pancreatic ascariasis.
- To evaluate the efficacy and technical feasibility of endoscopic worm extraction.
- To determine the role of anthelmintic therapy in preventing recurrence.
Main Methods:
- Retrospective review of 11 patients with cholangitis and pancreatitis due to Ascaris lumbricoides.
- Endoscopic retrograde cholangiopancreatography (ERCP) for diagnosis and intervention.
- Endoscopic worm extraction, with or without sphincterotomy, and subsequent anthelmintic treatment.
Main Results:
- Successful endoscopic worm extraction from the biliary tree was achieved in all applicable cases.
- Sphincterotomy facilitated worm removal from the common bile duct.
- Endoscopic extraction of worms from the pancreatic duct proved technically challenging.
Conclusions:
- Endoscopic extraction is effective for biliary Ascaris lumbricoides.
- Management of worms in the pancreatic duct requires specialized techniques or alternative approaches.
- Anthelmintic therapy is crucial for eradicating intestinal parasites and preventing disease recurrence.