Endoscopic diagnosis and extraction of biliary ascaris

A woman was admitted to hospital after several episodes of severe upper right abdominal pain and vomiting. Previously she had had cholecystectomy for gallbladder stones, and later endoscopic papillotomy to treat common duct stone. Endoscopic retrograde cholangiography diagnosed an Ascaris worm in the common bile duct. One end of the 20 cm long living worm was caught in a Dormia basket when it protruded through the papillotomy opening, and the worm extracted with the endoscope.