An Overview of Ascariasis Involvement in Gallbladder Disease: A Systematic Review of Case Reports

Inyang, Bithaiah; Koshy, Feeba Sam; George, Kitty; Poudel, Prakar; Chalasani, Roopa; Goonathilake, Mastiyage R; Waqar, Sara; George, Sheeba; Jean-Baptiste, Wilford; Ali, Amina Yusuf; Mohammed, Lubna

doi:10.7759/cureus.32545

Cited by 7 publications

(8 citation statements)

References 18 publications

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“…If a child presents with biliary colic and/or jaundice, it is important to consider other potential differential diagnoses such as cholelithiasis, cholecystitis, biliary tract stricture, and extrinsic compression of the bile ducts. 6 , 7 The diagnosis of hepatobiliary ascariasis is reached through clinical examination and radiologic investigation. Ultrasound is the preferred investigative modality with excellent sensitivity which remarkably increased the diagnosis of biliary ascariasis.…”

Section: Discussionmentioning

confidence: 99%

Intrabiliary Ascariasis: A Case Report of an Uncommon Cause of Acute Abdomen and Obstructive Jaundice in Children

Abore,

Bacha

2023

IMCRJ

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Background Intrabiliary ascariasis is an uncommon cause of biliary colic and obstructive jaundice among children due to the small size of the ampullary orifice. A high index of suspicion for patients living in an endemic area and radiologic examination are crucial for diagnosis and treatment. Case Presentation A 12-year-old male Ethiopian child presented with colicky right upper quadrant pain, nausea, and vomiting for 3 days. Physical examination showed slightly icteric sclera and slightly tender hepatomegaly. Laboratory and ultrasound examinations were suggestive of obstructive jaundice secondary to intra-biliary ascariasis. The child was admitted and followed by conservative management including maintenance fluid, nil per mouth, and analgesics. The abdominal pain and icterus resolved on his second and third day of admission, respectively. A follow-up ultrasound showed that the worm had migrated from the common bile duct. The patient was dewormed with a single dose of oral albendazole 400mg and discharged home. Currently, the patient is well and attending school. Conclusion Although biliary ascariasis is an uncommon cause of acute abdomen and obstructive jaundice, it should be suspected among patients from endemic areas presenting with suggestive clinical and laboratory features. Conservative treatment is the treatment of choice for uncomplicated biliary ascariasis patients.

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Section: Discussionmentioning

confidence: 99%

Intrabiliary Ascariasis: A Case Report of an Uncommon Cause of Acute Abdomen and Obstructive Jaundice in Children

Abore,

Bacha

2023

IMCRJ

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“…Imaging in our case showed curvilinear echogenicity of roundworm in the gallbladder and common bile duct with mild dilatation of the common bile duct. Other methods of imaging include endoscopic retrograde cholangiopancreatography, abdominal magnetic resonance cholangiopancreatography, and magnetic resonance imaging (MRI) 5 . Diagnosis is confirmed by stool examination for ova or adult worms.…”

Section: Discussionmentioning

confidence: 99%

“…But, in the absence of isolation of the microorganism, typical imaging findings can be helpful 4 . Other laboratory findings include leukocytosis, elevated liver enzymes, elevated C-reactive protein, eosinophilia, elevated serum bilirubin, elevated erythrocyte sedimentation rate, raised amylase and lipase, etc 5 . However, in our study the lab investigations showed mildly increased total and direct bilirubin, mildly elevated aminotransferases, elevated absolute eosinophil count, and normal total serum bile acid levels.…”

Section: Discussionmentioning

confidence: 99%

“…Biliary ascariasis is rare in non-endemic areas and has a female predominance with a 3:1 female-to-male ratio 4 . Diagnosis is confirmed through stool sampling, radiographic imaging, sonography, and minimally invasive diagnostic tests 5 . Most cases resolve after conservative treatment with an oral anthelmintic, but surgery may be required if treatment fails to eradicate the infection 3 .…”

Section: Introductionmentioning

confidence: 99%

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An unusual finding: Biliary ascariasis in a pregnant patient managed conservatively—a case report

katwal,

Oli,

Bhusal

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and importance: Biliary ascariasis, caused by Ascaris lumbricoides, is a rare condition, especially in non-endemic areas. However, it can present with complications such as biliary obstruction, requiring prompt diagnosis and management. This case report highlights the incidental detection and successful management of biliary ascariasis in a pregnant patient. Case presentation: A 26-year-old primigravida woman at 24 weeks gestation presented with mild icterus, anorexia, and gastrointestinal symptoms. Laboratory tests showed elevated bilirubin levels and peripheral eosinophilia. Abdominal ultrasound revealed the presence of roundworms in the gallbladder and common bile duct. The patient was managed conservatively with an anti-helminthic agent, resulting in the passing of a dead worm and the resolution of symptoms. Clinical discussion: Biliary ascariasis is a rare condition in non-endemic areas but should be considered in pregnant patients presenting with biliary symptoms. Prompt diagnosis is crucial, and imaging modalities such as abdominal ultrasound play a vital role. Conservative management with appropriate anti-helminthic therapy can effectively resolve symptoms and eliminate the infection. Conclusion: This case report emphasizes the importance of considering biliary ascariasis in pregnant patients with biliary symptoms. Timely diagnosis, utilizing imaging modalities, and initiating conservative management with anti-helminthic therapy can lead to successful treatment outcomes. Increased awareness and understanding of this condition can aid clinicians in providing optimal care to similar patients.

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“… 24 For patients that do not respond to conservative therapy, endoscopic and open surgical methods are best. 25 …”

Section: Discussionmentioning

confidence: 99%

Gallbladder Perforation with Choledochogastric Fistula Due to Ascaris Infestation, a Case Report

Amsalu¹,

Molla²

2023

IMCRJ

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We present a case of a 35-year-old Ethiopian female patient presented with right upper quadrant abdominal pain. Studies suspected gallbladder disease, for which she operated. Intraoperatively, gallbladder perforation with choledochogastric fistula was identified, with Ascaris lumbricoides (AL) worm in the common bile duct. Cholecystectomy was performed; common bile was repaired with T-tube and gastric repair. Patient was discharged 11 days after. On subsequent follow-up at the surgical referral clinic, the patient had no complaints.

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An Overview of Ascariasis Involvement in Gallbladder Disease: A Systematic Review of Case Reports

Cited by 7 publications

References 18 publications

Intrabiliary Ascariasis: A Case Report of an Uncommon Cause of Acute Abdomen and Obstructive Jaundice in Children

Intrabiliary Ascariasis: A Case Report of an Uncommon Cause of Acute Abdomen and Obstructive Jaundice in Children

An unusual finding: Biliary ascariasis in a pregnant patient managed conservatively—a case report

Gallbladder Perforation with Choledochogastric Fistula Due to Ascaris Infestation, a Case Report

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