Biliary ascariasis: CT, MR cholangiopancreatography, and navigator endoscopic appearance—report of a case of acute biliary obstruction

Ng, Koon‐Kwan; Wong, Ho-Fai; Kong, Man‐Shan; Chiu, Lee C.; Tan, Chih-Feng; Wan, Yung Liang

doi:10.1007/s002619900542

Cited by 39 publications

(27 citation statements)

References 14 publications

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“…A tendency to move, prophylactic antibiotics and lodging in the gallbladder may explain the absence of cholecystitis in the patients who presented to us early. The time period for spontaneous exit varies in relation to the number of worms, presence of cholecystitis, any anomaly of the cystic duct, and presence of worm in the CBD (12). An associated worm in the CBD may hamper escape of worms from the gallbladder, and in the case of our patients, this was associated with the longer duration of a worm trapped inside this organ.…”

Section: Discussionmentioning

confidence: 75%

Gallbladder ascariasis

WANI¹

2011

Turk J Gastroenterol

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Section: Discussionmentioning

confidence: 75%

Gallbladder ascariasis

WANI¹

2011

Turk J Gastroenterol

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“…The US findings of biliary ascariasis have been previously described: tubular, echogenic, non-shadowing structures, sometimes with a thin, longitudinal, central sonolucent line (2-4, 6, 8). Unless the operator carefully examines the biliary tract, however, the diagnosis of biliary ascariasis is difficult and in this respect, endoscopic retrograde cholangiography is a good but relatively invasive tool (4, 8-10).…”

Section: Discussionmentioning

confidence: 95%

Biliary Ascariasis: MR Cholangiography Findings in Two Cases

Hwang

Kim

et al. 2001

Korean J Radiol

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We describe the imaging features of two cases of biliary ascariasis. Ultrasonography and CT showed no specific abnormal findings, but MR cholangiography clearly demonstrated an intraductal linear filling defect that led to the correct diagnosis. MR cholangiography is thus a useful technique for the diagnosis of biliary ascariasis.he migration of Ascaris lumbricoides into the biliary tree is an uncommon but well-known complication of intestinal ascariasis and often results in biliary colic. The radiologic findings of biliary ascariasis have been described sporadically in the literature (1 3), which has stated that ultrasonography (US) is useful in identifying worms inside the biliary tree (3). We describe two cases of biliary ascariasis undetected by both US and CT but correctly diagnosed after magnetic resonance (MR) cholangiography. CASE REPORTS Case 1A 44-year-old woman was admitted with a history of epigastric pain which had started ten days prior to admission and had increased in intensity, and associated anorexia, nausea, and fever. Physical examination revealed tenderness in the epigastrium, though liver function tests revealed nothing abnormal and serum bilirubin, amylase and lipase levels, as well as her blood leukocyte count, were within normal limits. US showed no abnormal findings, but contrast-enhanced CT scanning revealed showed dilation of the intrahepatic bile ducts in the left lobe and slightly hyperattenuating lesions within the dilated bile ducts (Fig. 1A). MR cholangiography involving projection imaging and single-shot rapid acquisition using the relaxation enhancement (RARE) technique (repetition time, msec; effective echo time, 1200 msec; echo spacing, 11.5 msec; echo train length, 240; flip angle, 150 ; slab thickness, 70 mm; field of view, 300 mm; number of signals acquired, one; matrix, 240 256; and acquisition time, 6.32 sec) showed a hypointense tubular filling defect in the left intrahepatic bile duct (Fig. 1B). Endoscopic retrograde cholangiography demonstrated a linear filling defect along the left intrahepatic and common bile duct (Fig. 1C).The worm was endoscopically removed through the ampulla of Vater (Fig. 1D), no additional treatment being undertaken. The patient's clinical symptoms subsequently subsided. Case 2A 41-year-old woman was admitted with a ten-day history of epigastric pain. Physical

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“…An eosinophilia may be present and occurs in response to larval antigens. Occasionally, the diagnosis is made incidentally, when the nematode is spotted in the stool, on endoscopic examination, or is vomited up after general anesthetic (4,5). Treatment is with mebendazole 100 mg orally for 3 days or albendazole 400 mg by mouth as a single dose.…”

Section: Discussionmentioning

confidence: 98%