Pregnancy Complicated by Acute Pancreatitis with Ascariasis

Area of Science:

• Gastroenterology
• Obstetrics
• Parasitology

Background:

• Ascariasis lumbricoides infections are prevalent in tropical and subtropical regions.
• Common bile duct obstruction is a known complication of ascariasis.
• Biliary ascariasis during pregnancy is an uncommon presentation.

Observation:

• A 24-year-old pregnant female (34 weeks gestation) presented with epigastric pain radiating to the back and vomiting.
• Initial ultrasonography revealed a long, tubular hyperechoic structure within the gallbladder lumen, suggestive of ascariasis.
• The patient was diagnosed with acute pancreatitis secondary to live ascariasis in the biliary system.

Findings:

• The case demonstrates a rare instance of biliary ascariasis leading to acute pancreatitis in a pregnant patient.
• Diagnostic imaging successfully identified the parasitic presence within the gallbladder.
• The co-occurrence of ascariasis and acute pancreatitis in pregnancy underscores a significant clinical challenge.

Implications:

• This case emphasizes the need for heightened clinical suspicion for parasitic infections, including ascariasis, in pregnant women presenting with abdominal pain and pancreatitis.
• Early diagnosis and appropriate management of biliary ascariasis are crucial to prevent maternal and fetal complications.
• Further research into the prevalence and management of ascariasis during pregnancy is warranted to improve patient outcomes.