Biliary ascariasis: Ultrasonography, endoscopic retrograde cholangiopancreatography, and biliary drainage

Kamath, Patrick S.; Joseph, Daisy; Ramkumar, Chandran; Rao, Seema; Prakash, Meenakshi; D'Cruz, Ashley

doi:10.1016/0016-5085(86)90646-3

Cited by 50 publications

(20 citation statements)

References 5 publications

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“…The gallbladder may be normal or show signs of acute cholecystitis ultrasonographically. Dilation of the biliary tract may be evident if the worm(s) obstructs the common bile duct [10,11]. As in our first case, in patients with cholecystitis secondary to ascariasis, US is also a useful tool to detect a thickened gallbladder wall.…”

Section: Discussionsupporting

confidence: 50%

“…Various appearances of roundworms in the biliary tract and gallbladder have been described.8 A ribbon-like, non-shadowing structure with a highly echogenic wall and a less echogenic center image at the sagittal ultrasonography of the gallbladder is strongly demonstrated as a live Ascaris lumbricoides in the gallbladder. Other characteristic that have been described include "spaghetti-like appearance", "impacted worm sign", "inner tube sign", "double tube sign", and "bull's eye sign" [8][9][10]. Acoustic shadow is generally absent, unless there were associated gallstones.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to worms, the stones in the biliary tract appear as high-level echogenic structures with acoustic shadowing. While stones can also change position within bile ducts, their movement is related to changes in the posture of the patients [10,12] In conclusion, gallbladder ascariasis is a significant entity in endemic areas, and this disease may present as acalculous cholecystitis or empyema of the gallbladder. Although in some cases worms may migrate spontaneously back to the common bile duct.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasonography findings of biliary ascariasis as a rare cause of acalculous cholecystitis

Atalar¹,

Şalk²

2014

Basic Clin Sci

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ultrasonography findings of biliary ascariasis as a rare cause of acalculous cholecystitis

Atalar¹,

Şalk²

2014

Basic Clin Sci

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“…ERCP is helpful during the active phase and sometimes worms may be seen moving actively into the biliary tree from the duodenum (fig. 5) [19, 20, 21]. The worms migrate from the bile duct within 24 h up to 2 weeks.…”

Section: Nematodesmentioning

confidence: 99%

Biliary Parasites

et al. 1998

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Parasitic diseases of the biliary tract occur frequently in tropical and subtropical areas and cause high morbidity and mortality. In general, neither the clinical presentation nor the general laboratory findings are sufficiently unique to raise the possibility of a parasitic biliary infestation in the mind of the surgeon. Once considered, however, the presence of a parasitic biliary infestation is easily confirmed. Most commonly this is accomplished by the identification of the parasite in stools or duodenal contents. Ultrasonography, CT and MRI are not only important in the diagnosis of parasitic biliary diseases but also in the follow-up and surveillance. ERCP is an excellent diagnostic tool for demonstrating the presence of parasites in the biliary tree. Furthermore, ERCP is also used in the therapy of biliary parasitic infestations and carries less morbidity and mortality than the surgical approach. Surgery is only indicated in complicated cases. Mechanisms that may be effective against parasites include: antibodies; cytotoxic T cells; T-cell-induced activated macrophages; natural killer cells, and a variety of cells that mediate antibody-dependent cell-mediated cytotoxicity and modulators of the immune system such as cytokines. Future research has to focus on the importance of these mechanisms for the immune evasion by parasites.

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“…8 Previously, surgical treatment has been necessary for biliary ascariasis, 2,9 but recently a few reports have shown extraction of an ascaris worm from the biliary tree by Dormia basket through the papillotomy opening. 10,11 …”

Section: Discussionmentioning

confidence: 99%