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Biliary ascariasis presenting in the United States
The American Journal of Gastroenterology
|August 1, 1977
Summary
Biliary ascariasis, caused by Ascaris lumbricoides roundworms in bile ducts, often presents as abdominal pain without jaundice. Intravenous cholangiography aids diagnosis and nonsurgical treatment of this common global condition.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Radiology
Background:
- Ascariasis is a common helminthic infection globally, particularly in endemic regions.
- Infestation of the bile ducts (biliary ascariasis) by adult Ascaris lumbricoides is a recognized clinical entity.
Observation:
- The typical presentation involves upper abdominal colicky pain.
- Serum bilirubin levels are often normal or only slightly elevated, distinguishing it from obstructive jaundice.
- Adult roundworms within the bile ducts can be visualized via intravenous cholangiography.
Findings:
- Intravenous cholangiography provides a diagnostic radiographic appearance for biliary ascariasis.
- Nonsurgical treatment methods are effective when worms are identified.
- This case represents the first reported instance in North America/United Kingdom, highlighting underappreciation in non-endemic areas.
Implications:
- Increased awareness of biliary ascariasis is crucial in regions where it is not endemic.
- Radiographic diagnosis via cholangiography facilitates specific, non-surgical management.
- Understanding the varied presentations of ascariasis is important for global public health.