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Biliary ascariasis. A case report
1Department of Pediatric Surgery, Karadeniz Technical University Faculty of Medicine, Trabzon.
Insights
Biliary ascariasis, a rare complication of Ascaris lumbricoides infection, can mimic appendicitis. Early diagnosis via imaging and lab tests, followed by mebendazole treatment, is key for successful outcomes in children.
Area of Science:
- Gastroenterology
- Parasitology
- Pediatrics
Background:
- Ascaris lumbricoides is a common intestinal nematode globally.
- Complications of ascariasis are frequent, but biliary ascariasis is rare.
Observation:
- A child presented with abdominal pain, vomiting, and tenderness, initially suspected as acute appendicitis.
- Elevated serum alkaline phosphatase and amylase levels were noted.
- Ultrasonography and percutaneous cholangiography confirmed biliary ascariasis.
Findings:
- The case highlights the diagnostic challenge of biliary ascariasis.
- Diagnostic imaging and biochemical markers are crucial for identifying this rare condition.
- Successful treatment was achieved with mebendazole and antispasmolytic agents.
Implications:
- This case underscores the importance of considering rare parasitic infections in pediatric abdominal emergencies.
- Awareness of biliary ascariasis can lead to earlier diagnosis and effective treatment.
- Highlights the efficacy of mebendazole in treating Ascaris lumbricoides biliary obstruction.
Abstract:
Ascaris lumbricoides is a worldwide intestinal infestation that may cause various complications. Biliary ascariasis, however, is a rare condition. We describe a child with biliary ascariasis. The patient's clinical symptoms were pain, vomiting and abdominal tenderness, and she was thought to have acute appendicitis. However, laboratory examination revealed high serum alkaline phosphatase and amylase levels, and ultrasonography and percutaneous cholangiography demonstrated biliary ascariasis. The patient was successfully treated with mebendazole and antispasmolytic drugs.