Utilização da jejunostomia para extração endoscópica de Ascaris lumbricoides da via biliar principal em paciente com doença de Caroli

Valentim, Leonardo Fernandes; Souza, Ary Pires de; Vidal, Edison Iglesias de Oliveira; Menezes, José Geraldo

doi:10.1590/s0100-69912009000500018

Cited by 1 publication

(3 citation statements)

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“…With the patient under local anesthesia, they could access the jejunum and performed endoscopy through an enterotomy. A few small stones and a worm were removed from the bile duct [3].…”

Section: Discussionmentioning

confidence: 99%

“…Ascariasis is an endemic parasitic infestation in developing countries with precarious socioeconomic, health, and sanitary conditions [1][2][3]. It is most common in tropical and subtropical countries because of the warm and humid conditions of the soil [4].…”

Section: Introductionmentioning

confidence: 99%

“…Adult worms live in the small intestine, mostly in the jejunum [2,6]. These parasites have a propensity to explore orifices, ducts, and cavities [2,3,[6][7]. They can migrate to bizarre places such as the biliary tree, pancreatic ducts, lungs, appendix, Meckel's diverticulum, and peritoneal cavity [2,[4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Hepaticojejunostomy Anastomosis Worm Obstruction and Its Laparoscopic Management: A Case Report and Review of Literature

Das¹,

Rangad²

2022

Cureus

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We report a surprising case of intraoperatively detected worm obstruction of a hepaticojejunostomy anastomosis. The patient presented with acute cholangitis including fever, abdominal pain, obstructive jaundice and sepsis. Six years earlier, she had undergone open cholecystectomy with a right subcostal incision. Ultrasonography that night depicted the absence of the gall bladder and the presence of apparent stones in the common hepatic and common bile ducts. The patient was posted for laparoscopic exploration of common bile duct. Intraoperatively, worm obstruction was found in the hepaticojejunostomy anastomosis created during the previous operation. The obstruction was managed laparoscopically, and the patient recovered without any complications and was monitored for two years. In a search of PubMed and Google Scholar, we found reports of laparoscopy-assisted endoscopic retrograde cholangiopancreatography as an established method of relieving hepaticojejunostomy obstruction; however, we found no case of laparoscopic extraction of obstructing worms. Laparoscopic exploration of a hepaticojejunostomy anastomosis through the afferent Roux loop is a feasible and safe alternative to other advanced methods of endoscopic retrograde cholangiopancreatography, for which special technique, logistics, and training are required but may not be available in many parts of the world.

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“…With the patient under local anesthesia, they could access the jejunum and performed endoscopy through an enterotomy. A few small stones and a worm were removed from the bile duct [3].…”

Section: Discussionmentioning

confidence: 99%