Ascaris lumbricoides infestation of the gallbladder: case report

A 41-year-old woman presented with 3 days of right hypochondria and epigastric pain with vomiting. Laboratory results showed 4730 white blood cells, with eosinophils at 1.3% and C-reactive protein of 7.23 mg/L. We suspected hepatic colic. Ultrasonography revealed a long, floating, zigzagging tubular structure in the gallbladder, indicating the presence of a live worm. We concluded that the gallbladder was infested with Ascaris lumbricoides. The patient was treated with albendazole, leading to clinical improvement, and she was advised on prevention. Gallbladder infestation is a hepatobiliary complication of ascariasis. The worm appears as a mobile, zigzagging tubular structure within the gallbladder, resembling a "swimmer in the gallbladder." This appearance is easily recognizable on ultrasound and has been reported in cases of live Ascaris. In uncomplicated cases, antihelminthics may suffice. Monitoring is necessary because taking antiparasitic drugs can precipitate the onset of complications by retaining dead worms in the bile duct.