1/16. A rare cause of biliary pain in belgium.ascaris lumbricoides is the most frequent human helminthic parasite. Usually human ascariasis is poorly symptomatic but complications can arise due to worm migration. Erratic worm migration into the biliary tree is a rare but threatening condition regarding the associated complications: cholecystitis, pancreatitis, obstruction of bile ducts, liver abcesses and recurrent pyogenic cholangitis. We describe a case of a young belgian women suffering from recurrent biliary colics over a period of eight months with repeated normal ultrasound findings. ERCP proved being the only effective diagnostic procedure for a living biliary worm, which was successfully removed with a balloon catheter.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/16. Bilo-pancreatic ascaris lumbricoides infestation. Endoscopic discovery and removal.ascaris lumbricoides infestation is relatively rare in industrialized countries, and it occurs mainly in conditions in which hygiene is lacking. We describe here a case of a 39-year-old female from ex-Jugoslavia affected by recurrent hepatic colic. At entry ultrasonography revealed microlithiasis in the gallbladder and widening of the pancreatic head. The subsequent ERCP showed slight filling defects in the choledochus and an inflammation-like stricture of the papilla of Vater, and after endoscopic sphincterotomy we saw an outflow of dense bile and microlitholits. Thus, a standard surgical cholecystectomy was carried out and the patient was dismissed on the 3rd postoperative day without any symptoms. However, the patient was admitted again after four days for a new coliky pain attack. An upper endoscopy showed a 23 cm long mobile parasite in the duodenum: it was caught with the polypectomy loap, extracted and identified as A. Lumbricoides. The patient's symptoms disappeared after the endoscopic removal of the worm and she was dismissed the day after the worm's removal. No recurrence of symptoms was noted during a 1-year follow-up. This case showed that A. Lumbricoides infestation of the biliary tree should be considered when biliary and/or pancreatic symptoms recur, especially in patients coming from undeveloped countries. At the same time we showed that endoscopic removal is a safe and effective treatment for this infestation.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
3/16. pancreatitis with gallbladder ascariasis in a child: case report.A 10-year-old girl was admitted for abdominal pain for 1 week. Morning vomiting with 5 Ascaris and diarrhea with Ascaris were found. Radiograph of the abdomen disclosed no significant abnormality. Abdominal sonogram revealed a normal biliary tree; but mildly enlarged pancreatic thickness, and thickened gallbladder wall. Within the thickened gallbladder wall a linear echogenic structure with worm-like movement suspected of being Ascaris was found. We report this case because pediatric pancreatitis and a gallbladder wall thickened with worm-movement have rarely been reported. Urgent treatment and surgery are required for the very ill child with a tensely distended abdomen or signs of peritoneal irritation. early diagnosis is very important to prevent further complications. We emphasize the role of sonography in the diagnosis of this case and the prevention of progressive deterioration.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
4/16. Endoscopic removal of ascaris lumbricoides from the biliary tract as emergency treatment for acute suppurative cholangitis.ascariasis is the most common intestinal helminthiasis worldwide. Heavily infected individuals are prone to develop bowel obstruction or perforation as well as biliary disease. Nevertheless, the presence of roundworms in the biliary tree outside endemic areas is very uncommon. The migration of these worms to the biliary system can cause biliary colic, pancreatitis, or even acute suppurative cholangitis with hepatic abscesses and septicemia.We report here on 2 infants with 14 and 15 months and a 9-year-old boy who suffered from massive biliary ascariasis and who presented with acute suppurative cholangitis. All cases were successfully treated by endoscopic retrograde cholangiopancreatography with worm extraction and adjuvant medical therapy.physicians should be aware of ascariasis in patients with pancreatobiliary symptoms who have traveled to endemic areas or in immigrants from these areas.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
5/16. An unusual cause of recurrent biliary colics.Hepato-biliary ascariasis is a rare condition in non-endemic areas; however, it should always be taken into account in patients with recurrent biliary colics and/or cholangitis, since these are among the most frequent modes of clinical presentation. We report a case of a young woman suffering from recurrent biliary colics in whom a diagnosis of biliary ascariasis was made. Endoscopic retrograde cholangiopancreatography with sphincterotomy and endoscopic extraction of the worm, using a Dormia basket, proved to be a safe and effective procedure for removing the living Ascaris from the biliary tree and relieving symptoms. In the era of worldwide travels, physicians in Western countries should be more aware of this infection especially in patients with biliary symptoms who have travelled to endemic areas or immigrant from endemic countries.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
6/16. Biliary ascariasis--a worm in the duct.OBJECTIVE: Migration of ascaris lumbricoides into the biliary tree may cause biliary obstruction, cholangitis or pancreatitis. Although common in endemic areas, none of these complications have previously been reported in australia. We report here a case of obstruction of the common bile duct by an ascarid. CLINICAL FEATURES: A 62-year-old female Vietnamese migrant presented with cholangitis and underwent a cholecystectomy. Subsequently, ultrasound and cholangiography revealed an ascarid in the common bile duct. INTERVENTION and OUTCOME: This worm was endoscopically removed and the patient's symptoms rapidly resolved. CONCLUSION: As a result of increased migration to australia, such cases will be recognised more frequently in the future. patients at risk should be carefully imaged prior to definitive therapy.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
7/16. Sonographic diagnosis of biliary ascariasis.In an 11.5-year-old boy with obstructive jaundice sonography revealed a worm-like structure within the dilated biliary tree. Cross-section showed a bull's eye configuration, whereas longitudinal planes demonstrated an echogenic strip with a central longitudinal anechogenic tube. Diagnosis of ascariasis was established by identification of ascarid eggs in the stool. After anthelminthic treatment several ascarid worms were excreted with the stool.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
8/16. CT findings in biliary and pancreatic ascariasis.In a child with biliary and pancreatic ascariasis CT demonstrated liver abscesses and a pancreatic pseudocyst, in addition to air in the biliary tree and main pancreatic duct.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
9/16. Massive thrombosis as a result of triple infestation of the pulmonary arterial circulation by Ascaris, Candida, and mucor.A 35-year-old man with a brief history of dyspnea and fever experienced rapid progressive respiratory distress and died shortly after being hospitalized. Postmortem examination revealed thrombotic occlusion of the pulmonary tree; the thrombotic material showed ascaris lumbricoides, candida albicans, and mucor. This rare coincidence is an unexpected complication of ascariasis that has not been described previously.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
10/16. Biliary ascariasis--endoscopic aspects. Report of 4 cases.Retrograde cholangiography was carried out in 4 small children with suspected roundworm infestation of the biliary tree. An adult-sized side-viewing fibre-optic duodenoscope was employed, and a general anaesthetic was given in each case. Roundworms were frequently seen protruding from the papillary orifice when biliary infestation was present. Cannulation of the duodenal papilla was shown to be eminently feasible in these small children, whose average weight was 12,4 kg. The degree of infestation and the response to vermifuge therapy could be determined with precision by retrograde cholangiography. It is suggested that this procedure has a place in the management of the complicated case of biliary ascariasis, and that it should certainly be considered when surgery is contemplated.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
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