HEPATOBILIARY ASCARIASIS COMPLICATED BY PANCREATITIS

Authors

  • Muhammad Azhar Division of Medicine, Mayo Hospital, King Edward Medical University, Lahore
  • Ali Sibtain Farooq Sheikh Division of Medicine, Mayo Hospital, King Edward Medical University, Lahore
  • Asim Khan Division of Medicine, Mayo Hospital, King Edward Medical University, Lahore
  • Saqib Mustafa Division of Medicine, Mayo Hospital, King Edward Medical University, Lahore
  • Imran Ali Shah Division of Medicine, Mayo Hospital, King Edward Medical University, Lahore
  • Bilal Hameed Division of Medicine, Mayo Hospital, King Edward Medical University, Lahore

Abstract

Ascaris lumbricoides is the commonest organism causing soil-transmitted helminth infection. It is particularly common in poor sanitary conditions. Nevertheless, involvement of the gallbladder by Ascaris is a rare entity. A lady presented to us with long-standing history of vague abdominal symptoms suggesting dyspepsia. Ultrasound showed a tube like structure invading the biliary channels. Serum amylase was elevated and the patient was managed conservatively, as for acute pancreatitis. She improved clinically, but subsequent imaging with magnetic resonance cholangiopancreatography revealed worm in the gallbladder. Laparoscopic cholecystectomy was done and Ascaris lumbricoides was removed. Ascaris infestation is an important differential diagnosis of patients with upper abdominal symptoms and screening with stool examination and ultrasound is warranted in high-risk population. Keywords: Ascaris lumbricoides, soil-transmitted helminthes, gallbladder, cholecystitis, pancreatitis, dyspepsia

References

Pullan RL, Smith JL, Jasrasaria R, Brooker SJ. Global numbers of infection and disease burden of soil transmitted helminth infections in 2010. Parasit Vectors 2014;7:37.

Ziegelbauer K, Speich B, Mäusezahl D, Bos R, Keiser J, Utzinger J. Effect of sanitation on soil-transmitted helminth infection: systematic review and meta-analysis. PLoS Med 2012;9(1):e1001162.

Wani I. Gallbladder ascariasis. Turk J Gastroenterol 2011;22(2):178–82.

Bahú Mda G, Baldisserotto M, Custodio CM, Gralha CZ, Mangili AR. Hepatobiliary and pancreatic complications of ascariasis in children: a study of seven cases. J Pediatr Gastroenterol Nutr 2001;33(3):271–5.

Heggers JP, Muller MJ, Elwood E, Herndon DN. Ascariasis pneumonitis: a potentially fatal complication in smoke inhalation injury. Burns 1995;21(2):149–51.

Wu S. Sonographic findings of ascaris lumbricoides in the gastrointestinal and biliary tracts. Ultrasound Q 2009;25(4):207–9.

Hashmi MA, De JK. Biliary ascariasis on magnetic resonance cholangiopancreatography. J Glob Infect Dis 2009;1(2):144–5.

Nxasana N, Baba K, Bhat V, Vasaikar S. Prevalence of intestinal parasites in primary school children of mthatha, eastern cape province, South Africa. Ann Med Health Sci Res 2013;3(4):511–6.

Khan AS, Bhowmik B, Hakim HAN, Islam MA. Outcome of Conservative Management in Biliary Ascariasis – A Study of 98 Cases. J Dhaka Med Coll 2010;19:25–8.

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Published

2015-06-20

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