Endoscopic management of biliary ascariasis: A case report

Abstract

BACKGROUND Biliary ascariasis is rare but remains the most common parasitic infection in remote areas and in people with poor medical conditions. Here, we reported a case of biliary ascariasis in order to raise awareness of possible parasitic infections. CASE SUMMARY A 68-year-old female was admitted to the emergency room of the Affiliated Hospital of Guizhou Medical University on 28 September 2017, with chief complaint of pain in the right upper abdomen. Ultrasonography of the abdomen showed that the upper segment of the common bile duct was slightly dilated with parallel tubular structures, indicative of biliary ascariasis. Endoscopic retrograde cholangiopancreatography was performed under general anesthesia on 29 September 2017, and an adult Ascaris lumbricoides worm was observed. After the worm was removed from the bile duct, the patient’s pain immediately subsided. The patient was successfully cured, without any complications. CONCLUSION This report emphasizes the need for physicians to consider biliary ascariasis as a possible cause when treating cases of biliary colic.

A Patient With Idiopathic Recurrent Acute Pancreatitis Demystified by Endoscopic Ultrasound

“…In cases of poor medical response, surgical intervention may be considered. ERCP is effective for both diagnosis and treatment, achieving high success rates in the removal of worms from the biliary tree [ 7 ]. Preventive measures include the enhancement of sanitation, personal hygiene, health education, and the implementation of deworming programs [ 2 ].…”

Ascending cholangitis in a child: A rare case of biliary Ascariasis visualized by ultrasound

“…The management of hepatobiliary ascariasis involves a comprehensive approach, combining endoscopic and pharmacological strategies to remove worms, resolve complications, and prevent recurrence. ERCP is the gold standard for diagnosing and treating hepatobiliary ascariasis, enabling visualization, worm extraction, and bile duct clearance [9 , 11] . Anthelmintic agents such as Albendazole or Mebendazole are used to eliminate worms and prevent re-infestation.…”

A Case Report on Biliary Ascariasis

“…Three modalities are available for the treatment of Ascariasis: non-surgical management, surgical management for patients with poorly responsive to the medications or those who are complaining of severe infection, and endoscopic management. ERCP represents an endoscopic diagnostic and therapeutic method, which has been efficiently used to visualize and remove the worms from the biliary tract at the time of diagnosis [10].…”