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Biliary ascariasis: report of a case

C H Chen1, J M Wong, Y T Hwang

  • 1Department of Internal Medicine, National Taiwan University Hospital, Taipei, R.O.C.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|May 1, 1994
PubMed
Summary

Ascaris infection caused acute cholangitis and jaundice in an Aboriginal woman. Endoscopic removal of the roundworm from the bile duct led to rapid improvement.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Infectious Diseases

Background:

  • Ascariasis, a common parasitic roundworm infection, can lead to biliary tract obstruction.
  • Biliary ascariasis presents with symptoms like cholangitis and obstructive jaundice.
  • Early diagnosis and intervention are crucial for managing biliary ascariasis.

Observation:

  • A 64-year-old Aboriginal female presented with acute cholangitis and jaundice.
  • Abdominal ultrasonography revealed a linear tubular structure in the dilated common bile duct.
  • Duodenoscopy identified a live Ascaris protruding from the papilla of Vater.

Findings:

  • Endoscopic extraction of the Ascaris provided immediate relief from cholangitis.
  • Endoscopic retrograde cholangiography confirmed another worm in the common bile duct, which later spontaneously passed.
  • Intestinal imaging showed multiple filling defects, and the patient expelled five worms after pyrantel pamoate treatment.

Implications:

  • This case highlights the importance of considering parasitic infections in biliary obstruction, particularly in endemic areas.
  • Endoscopic procedures are effective for diagnosing and treating biliary ascariasis.
  • Prompt treatment of ascariasis can prevent severe complications such as recurrent cholangitis and liver abscesses.

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