Ascaris lumbricoides in hepatic vein; a case of a common parasite in an ectopic site

Abstract

Introduction: Ascaris lumbricoides is amongst the common helminthic disease worldwide. It is more prevalent in tropical and subtropical regions, especially in communities with dearth of basic amenities and poor socioeconomic conditions. Despite high incidence of intestinal ascariasis, and rare involvement of biliary and pancreatic tree, ectopic involvement of hepatic vein with adult worm is extremely rare. Case Report: We report a case of 53-year-old male senior civil servant that presented with two months history of vague abdominal pain and nausea. Abdominal ultrasound scan revealed adult worm within the main trunk of the intrahepatic portal vein. Sonography was repeated on the 14th day after seven days of oral albendazole 400 mg daily. It showed complete disappearance of the adult worm devoid of residual focal lesion. Conclusion: We report a rare case of intrahepatic adult worm in-situ portal vein that responded to oral antihelminthes. Sonography is an inexpensive, safe, non-invasive and valuable investigative tool that allows the observation of ascaris lumbroicoides in the liver.