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Ascending cholangitis in a child: A rare case of biliary Ascariasis visualized by ultrasound
Abubeker Fedlu Abdela1, Michael Teklehaimanot Abera1, Fathia Omer Salah1
1Addis Ababa University, College of Health Sciences, Department of Radiology, Addis Ababa, Ethiopia.
Insights
Biliary ascariasis, a rare cause of biliary blockage in children due to Ascaris lumbricoides, can lead to ascending cholangitis. Real-time ultrasound revealed the characteristic double tube sign, aiding diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Radiology
Background:
- Biliary ascariasis, caused by Ascaris lumbricoides infestation of the biliary system, is an uncommon yet significant cause of biliary obstruction in pediatric patients.
- Ascending cholangitis is a serious infection that can arise secondary to biliary obstruction.
Purpose of the Study:
- To report a case of pediatric biliary ascariasis presenting with ascending cholangitis.
- To highlight the diagnostic utility of real-time abdominal ultrasound in identifying biliary ascariasis.
Main Methods:
- Case report detailing clinical presentation, diagnostic workup, and management.
- Real-time abdominal ultrasound examination to visualize the biliary system.
Main Results:
- The patient presented with clinical and radiological evidence of ascending cholangitis.
- Ultrasound imaging demonstrated the characteristic "double tube sign," indicative of Ascaris lumbricoides within the common bile duct.
Conclusions:
- Biliary ascariasis is a potential cause of ascending cholangitis in children and should be considered in endemic areas.
- The "double tube sign" on ultrasound is a valuable diagnostic marker for biliary ascariasis.
Abstract:
Biliary ascariasis, resulting from the infestation of the biliary system by the roundworm Ascaris lumbricoides, is a rare but important cause of biliary blockage in children. In this case report, we present the clinical and radiological findings of a child who presented with symptoms and signs of ascending cholangitis, which followed biliary ascariasis. Double tube sign, typical for biliary ascariasis, was visualized on real time abdominal ultrasound examination.
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