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Biliary ascariasis in children

M R Davies, H Rode

    Progress in Pediatric Surgery
    |January 1, 1982
    PubMed

    Insights

    Ascariasis is a frequent cause of acute abdominal emergencies in children, particularly affecting the biliary system. Early diagnosis and management are crucial to prevent serious complications like cholangitis and pancreatitis.

    Area of Science:

    • Pediatric Surgery
    • Infectious Diseases
    • Gastroenterology

    Background:

    • Ascariasis is the most common cause of acute abdominal emergencies in children at Cape Town Children's Hospital.
    • A significant number of pediatric surgical ward admissions are due to ascariasis.
    • Biliary ascariasis is prevalent, necessitating specific diagnostic considerations.

    Purpose of the Study:

    • To describe the host/parasite relationship in ascariasis.
    • To discuss the invasion of the ampulla of Vater by Ascaris.
    • To evaluate diagnostic and management strategies for biliary ascariasis and its complications.

    Main Methods:

    • Review of over a thousand pediatric cases of ascariasis admitted to surgical wards.
    • Evaluation of diagnostic methods including intravenous cholangiography, radiography, ultrasonography, and duodenoscopy.
    • Analysis of surgical findings and patient management.

    Main Results:

    • 424 cases of biliary ascariasis were identified.
    • Routine intravenous cholangiography is recommended for suspected ascariasis with abdominal pain.
    • Ninety-five percent of cases were uncomplicated, but 5% developed complications such as cholangitis, perforation, cholecystitis, and pancreatitis.

    Conclusions:

    • Ascariasis frequently presents as an acute abdominal emergency in children.
    • Biliary ascariasis requires prompt diagnosis and management.
    • Complications of ascariasis, though less common, necessitate detailed understanding for effective surgical intervention.

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