Management of Biliary Ascariasis in Pregnancy

Shah, Omar Javed; Robanni, Irfan; Khan, Fayaz Ahmad; Zargar, Showkat Ali; Javid, Gul

doi:10.1007/s00268-005-0015-z

Cited by 35 publications

(16 citation statements)

References 32 publications

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“…[14] These patients usually present with biliary colic (56%), acute cholangitis (25%), acute cholecystitis (13%), acute pancreatitis (6%), and rarely, pancreatic abscess (less than 1%). [15] We have found in our study, in accordance with a previous study,[1415] that adult females were five times more sufferers than males. Similar presentation was also seen in this series, with biliary colic (94.9%); acute cholangitis (21.7%), obstructive jaundice (13.8%), choledocholithiasis (14.5%), acute pancreatitis (7.2%), acute cholecystitis (4.3%), liver abscess (1.4%), hepatolithiasis (2.2%) and pancreatic abscess (0.7%).…”

Section: Discussionsupporting

confidence: 93%

Comparative study on presentation of biliary ascariasis with dead and living worms

Alam

Mustafa

Rahman

et al. 2010

Saudi J Gastroenterol

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Background/Aim:Ascariasis is a common parasitic infestation in Asia and Latin America. The most serious presentation is biliary and pancreatic ascariasis (BPA). The aim of the present study was to compare the clinical presentation of BPA with dead worms with that with living worms.Materials and Methods:We included 138 consecutive cases of BPA that occured during the period January 2005 to July 2009. All the patients had endoscopically proven BPA consisting of living or dead worms. Comparison was done by chi-square and independent t tests.Results:The age (mean ± SD) of the patients was 36.8 ± 16.1 years. Prevalence ratio between male and female patients was 1:5. Ninety eight patients contained living worms and 40 had dead worms. Males were more prone to develop dead worm BPA. The commonest presentation was biliary colic (131; 94.9%); others were acute cholangitis (30; 21.7%), obstructive jaundice (19; 13.8%), choledocholithiasis (20; 14.5%), acute pancreatitis (10; 7.2%), acute cholecystitis (6; 4.3%), liver abscess (2; 1.4%), hepatolithiasis (3; 2.2%), stricture of common bile duct (2; 1.4%), pancreatic abscess (1; 0.7%) and cirrhosis of liver (1; 0.7%). Choledocholithiasis, hepatolithiasis, liver abscess and cirrhosis were associated only with dead worms. We could successfully remove all the worms with endoscopic interventions, but 5 patients required surgical intervention as there were strictures and stones within the biliary tree or Ascaris were in gallbladder. Recurrences of stone and cholangitis occurred only in those with dead worms.Conclusion:Biliary ascariasis with dead worms is more dangerous than that with living worms. Endoscopic or surgical intervention may be required repeatedly in those with dead worms.

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Section: Discussionsupporting

confidence: 93%

Comparative study on presentation of biliary ascariasis with dead and living worms

Alam

Mustafa

Rahman

et al. 2010

Saudi J Gastroenterol

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“…HPA is commonly seen in pregnant women, possibly due to hormone-induced relaxation and dilatation of ampullary orifice, making it easier for ascarides to enter the ducts. On the same analogy, worms in pregnant women reach gall bladder more often than in non-pregnant population[44-46]. Biliary surgery/interventions namely cholecystectomy, choledocholithotomy, sphincteroplasty, and endoscopic sphincterotomy performed for gallstone disease predisposes patient to ductal invasion by ascarides[11,31,47].…”

Section: Hepatobiliary and Pancreatic Ascariasismentioning

confidence: 99%

Hepatobiliary and pancreatic ascariasis

Khuroo

Rather

Khuroo

et al. 2016

WJG

111

129

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Hepatobiliary and pancreatic ascariasis (HPA) was described as a clinical entity from Kashmir, India in 1985. HPA is caused by invasion and migration of nematode, Ascaris lumbricoides , in to the biliary tract and pancreatic duct. Patients present with biliary colic, cholangitis, cholecystitis, hepatic abscesses and acute pancreatitis. Ascarides traverse the ducts repeatedly, get trapped and die, leading to formation of hepatolithiasis. HPA is ubiquitous in endemic regions and in Kashmir, one such region, HPA is the etiological factor for 36.7%, 23%, 14.5% and 12.5% of all biliary diseases, acute pancreatitis, liver abscesses and biliary lithiasis respectively. Ultrasonography is an excellent diagnostic tool in visualizing worms in gut lumen and ductal system. The rational treatment for HPA is to give appropriate treatment for clinical syndromes along with effective anthelmintic therapy. Endotherapy in HPA is indicated if patients continue to have symptoms on medical therapy or when worms do not move out of ductal lumen by 3 wk or die within the ducts. The worms can be removed from the ductal system in most of the patients and such patients get regression of symptoms of hepatobiliary and pancreatic disease.

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“…Several reports exist about the successful medical treatment of gallbladder ascariasis. 5,8,10,[12][13][14]18,19 Sometimes surgery 4,6,8,10,16 or the endoscopic procedures 7,8,10 such as endoscopic retrograde cholangiopancreatographic examination are required. Albendazole and mebendazole are first-line agents for the treatment of ascariasis.…”

Section: Discussionmentioning

confidence: 99%

“…Pregnant women may be more susceptible due to relaxant effect of hormones on the smooth muscle of the bile ducts. 8 Ultrasonography (US) is an important noninvasive diagnostic procedure in the work-up of these patients, 4,9,10 which usually describe a clinical picture suggesting a gallstone disease. It is one of the most used diagnostic tools in the emergency department (ED) because it is safe, not invasive, rapid to perform and, consequently avoids wasting of time for the diagnosis and the treatment of several pathological conditions in the ED.…”

Section: Introductionmentioning

confidence: 99%

An alien in the gallbladder. A rare case of biliary ascariasis in an Italian emergency department

et al. 2016

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Ascariasis is a common infection in many developing countries. The prevalence of ascariasis is related to poverty, poor hygienic and sanitary conditions. The adult form of Ascaris lumbricoides usually resides in the human intestinal lumen (more frequently in the jejunum and middle ileum) and does not cause symptoms. However, it can occasionally cause severe complications such as intestinal obstruction or perforation peritonitis. Its migration into the biliary tract is not uncommon but gallbladder involvement is very rare. Abdominal ultrasonography is essential to detect the presence of this parasite. In this article, we describe the radiologic findings, clinical manifestations and successful medical treatment of a patient with gallbladder ascariasis diagnosed in an emergency setting.

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Management of Biliary Ascariasis in Pregnancy

Cited by 35 publications

References 32 publications

Comparative study on presentation of biliary ascariasis with dead and living worms

Comparative study on presentation of biliary ascariasis with dead and living worms

Hepatobiliary and pancreatic ascariasis

An alien in the gallbladder. A rare case of biliary ascariasis in an Italian emergency department

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