BILIARY ASCARIASIS IN CHILDREN

Authors

  • JAVED ALAM
  • MEHAR DIL KHAN WAZIR
  • ZARDAD MUHAMMAD

Abstract

Background: Ascariasis is very common in this part of the world. Biliary Ascariasis is rare but is the commonestextra-intestinal complication. Methods: This study was conducted at Ayub leaching Hospital, Abbottabad, a tertiary'care hospital. Five cases of biliary Ascariasis were studied from December 1999 to January 2001. History of passageof worms in stool or vomiting and abdominal pain was taken. After clinical evaluation. Stool Examination, Serumamylase, LFTs, and complete blood picture (CP) were done. Ultrasound abdomen was done as a basic tool fordiagnosis. All cases were given Piperazine. Spasmolytics were also given to relax sphincter of oddi to release theworms. Surgical opinions were also taken for each case. Results: About 80% Children were above 10 years of age.One case was 1 % years old. Most common symptom was right upper quadrant abdominal pain. Previous history ofpassage of worms in stool and vomitus was also present. Two children developed complications of Biliary Ascariasisi.e., Cholecystitis and Portal empyema and responded to antibiotics. All children became symptom free in about 48hours of treatment. Ultrasound was found to be a reliable, non-invasive, and quick tool for diagnosis and follow up.

References

Piggot J. Hansberger EA. Jr Naojie RC Human Ascariasts Ain

J Clin Pathol 1970 53223-34

Huroo Ms, Zargar SA. Mahajan R: Hepatobiliary and

Pancreatic Ascariasis in India. Lancet 335 1503.1990.

Ali and others. Lady reading hospital Peshawar J Cline

Ultrasound 1996 Jun 24(25): 135-41

Danaci M. Belet U, Selcuk MB Akhan H, Bastemir M, Pediatr

Radiol 1999 Feb: 29(2). SO

Dancer M, Bale! U, Blat V, Incesul MR Imaging features of

biliary Ascariasis, AIR 1999:173:503.

Rama anand and others Indian J Radiol Imaging 1999:9‘ 1.23.

Ferreyra Np. Cerri GG. Hepato-gastroenterology 1998 JulAug:45(22)'932-7.

Behrman, K Legman, Arvin. Nelsen Textbook of Pediatrics

I6th Edition.

Sarihan-H, Gurkok-s, Sari-A. Turk-J-Pediatr. 1995 OctDec;37(4):399-402.

Sandouk F et al.. Pancreatic-biliary Ascariasis; Exp of 300

Cases Am-J-Gastroenterol. 1997 Dec;92(12):2264-7.

Lauw JH, Abdominal Complication of Ascaris Infection in

children. British Journal of Surgery 1966; 56; 510-21

Pereira PE and others. Pathology of Pyogenic Liver Abscess

in children. Padiatr Dev Pathol 1999 Nov-Dec,2(6) 537-43.

Misra SP, Dwiredi Mr. Clinical Features and Management of

biliary Ascariasis in No endemic area. Postgrad Med J 2000

Jan;76(891):29-32.

Endoscopy-assisted emergency treatment of gastroduodenal

and Pancreatobiliary ascariasis, Endoscop.l996: Sep;28(7):

-32

Schulman A Ultrasound appearances of intra and extrahepatic

biliary Ascariasis Abdom-Imagmg 1998 Jan-Feb 23(1) 60-6

El Sheikh Mohamed AR, al Karawi Ma , Yasawy MI Modern

techniques in diagnosis and treatment of gastrointestinal and

biliary tree parasites Hepatogastroentrology 1991 Apr . 38 (2);

-8.

Gomez NA, Leon CJ, Ortiz O Ultrasound in the diagnosis of

round worms in gall bladder and common bile duct Report of

four cases. Surg Endosc. 1993 Jul-Aug. 7(4). 339-42

Dobrilla G. Valentini M, Filippini M A case of common bile

duct Ascariasis diagnosed by Duodenoscopy Endoscopy 1976

Nov;8 (4): 211-4.