Laproscopic Management of Wandering Biliary Ascariasis

Jethwani, Umesh; Singh, Gurjot; Sarangi, P. P.; Kandwal, Vipul

doi:10.1155/2012/561563

Cited by 17 publications

(24 citation statements)

References 6 publications

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“…It can be found at any age but especially in children and young adults as in our patient [5]- [7]. The migration of Ascaris lumbricoides in the biliary ducts is the most common surgical complication of ascariasis [6]. According to Sandouk F. et al, in patients with biliary ascariasis, cholecystectomy and endoscopic sphincterotomy are risk factors accounting respectively in 80% and 77% [1].…”

Section: Discussionmentioning

confidence: 85%

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Biliary Ascariasis: An Unusual Cause of Biliary Colic

Thiam¹,

Guèye²,

Touré³

et al. 2015

OALib

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Introduction: Ascariasis by Ascaris lumbricoides is a cosmopolitan disease. Biliary ascariasis is unusual in our country. We report a case of biliary ascariasis revealed by biliary colic. Observation: A 22-year-old woman with no particular history was received for biliary colic associated to vomiting without fever or bowel disorders. On examination, there were pain and defense at the right upper quadrant and a Murphy sign. Moreover, the clinical examination was normal. Blood cells count, renal function, liver function, coagulation and blood ionogram were normal. The abdominopelvic ultrasonography showed a probable parasitosis of the bile duct with gallbladder sludge and dilatation of the common bile duct. The abdominopelvic CT scan revealed intrahepatic and common bile duct (CBD) dilatation and organic image in the common bile duct. Right subcostal laparotomy was allowed to extract an ascaris blocking the common bile duct. A cholecystectomy and drainage of the bile duct with a Kehr drain were performed. The postoperative course was marked by wound surgical suppurative resolved by treatment. She was discharged on the 9 th post-operative day. T-tube was removed on the 21 st post-operative day after normal cholangiography. Conclusion: Biliary ascariasis is rare in our regions. The diagnosis must be kept in mind in case of biliary colic and ultrasound confirm the diagnosis. Surgical treatment gives good results in our regions.

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Section: Discussionmentioning

confidence: 85%

“…The symptoms are variable. Its diagnosis may be accidental during ultrasonography or cholecystectomy [6]. It can be revealed by recurrent biliary colic, cholecystitis, cholangitis, liver abscesses and pancreatitis [1] [6].…”

Section: Discussionmentioning

confidence: 99%

Biliary Ascariasis: An Unusual Cause of Biliary Colic

Thiam¹,

Guèye²,

Touré³

et al. 2015

OALib

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“…MR cholangiopancreatography can also be used for investigation of bile and pancreatic ducts 2–13. On the contrary, when ERCP is unsuccessful, a laparoscopic approach with further choledochotomy and extraction of the worm can be used 13. Laparotomy can also be performed in complicated cases, such as bowel perforation and peritonitis 16.…”

Section: Discussionmentioning

confidence: 99%

Ascariasis of the pancreatic duct

et al. 2015

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Ascariasis is a common helminthic disease worldwide, although Lithuania and other European countries are not considered endemic areas. The presence of the Ascaris worm in the biliary tree causes choledocholithiasis-like symptoms. We report a case of pancreatic duct ascariasis causing such symptoms. A 73-year-old Lithuanian woman underwent endoscopic retrograde cholangiopancreatography (ERCP) suspecting choledocholithiasis. Contrast injection into the common bile duct demonstrated a slightly dilated biliary tree without any filling defects, and the tail of an Ascaris worm protruding from the opening of the papilla Vater. The worm was captured by a snare but escaped deep into the duct. After a small wirsungotomy the worm was retrieved from the pancreatic duct. The patient received a 150 mg dose of levamisole orally repeated 7 days later and was discharged after complete resolution of symptoms. This first reported sporadic case of pancreatic duct ascariasis in Lithuania was successfully treated with ERCP and Levamisole.

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“…Medical management fails if there is a distal stone or stricture in the common bile duct. Surgical intervention in the form of endoscopic removal, laparoscopy or open surgery may be required in such cases [1][2][3]. …”

Section: Dear Editormentioning

confidence: 99%

Biliary ascariasis: A case report

2015

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Ascariasis is the most common helminthic infection of human beings. The causative organism is ascaris lumbricoides. This organism usually lives in the small intestine. Rarely, however, it may enter into the biliary tree via the ampulla of vater.A 35-year-female presented to the surgical outpatients department complaining of a colicky pain in the right upper abdomen and nausea over the past three days. On examination, she was found to be icteric and she displayed tenderness in the upper abdomen. Her laboratory investigations revealed low haemoglobin (9 gm%) and raised direct bilirubin (2.4 mg%) and alkaline phosphatase (304 IU). Abdominal sonography depicted a distended gallbladder and sludge in the common bile duct. Magnetic Resonance Cholangio-Pancreatography (MRCP) showed a tubular structure in the common bile duct (Figure 1). A diagnosis of biliary ascariasis was made, and the patient was started on albendazole 400 mg once a week for three weeks. The patient improved symptomatically with this conservative treatment.Biliary ascariasis is more common after sphincterotomy or biliary-enteric anastomosis. Pregnant females are also more prone probably because of the relaxing effect of hormones on the biliary smooth muscles. It often presents as abdominal colic, cholecystitis, cholangitis, pancreatitis etc. Gallbladder ascariasis is less commonly seen due to a narrow and tortuous cystic duct. About 95% of patients respond well to medical management. Medical management fails if there is a distal stone or stricture in the common bile duct. Surgical intervention in the form of endoscopic removal, laparoscopy or open surgery may be required in such cases [1-3]. Figure 1.

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Laproscopic Management of Wandering Biliary Ascariasis

Cited by 17 publications

References 6 publications

Biliary Ascariasis: An Unusual Cause of Biliary Colic

Biliary Ascariasis: An Unusual Cause of Biliary Colic

Ascariasis of the pancreatic duct

Biliary ascariasis: A case report

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