1/7. 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 = extraction (Clic here for more details about this article) |
2/7. Biliary complications of large echinococcus granulosus cysts: report of 2 cases and review of the literature.Hydatid cysts are often incidentally found and remain clinically silent. However complications can occur. We present 2 patients who developed biliary complications due to a large hydatid cyst. In the first patient compression on the intrahepatic bile ducts and cystic duct by the cyst, caused cholangitis and cholecystitis. Moreover the cyst had ruptured into the right intrahepatic bile ducts. A sphincterotomy was performed with extraction of hydatid sand. A pericystectomy was necessary because of infectious deterioration of the patient. albendazole was continued for 8 weeks after surgery. The second case presented with jaundice and weight-loss since 1 month. A large hydatid cyst caused compression on the bile duct bifurcation with proximal bile duct dilatation. A cystectomy was performed 2 weeks after albendazole therapy initiation, which was continued for 8 weeks after surgery. Follow-up of both surgical interventions was unremarkable. Although echinococcus granulosus in not prevalent in belgium, we must be aware of this pathology in patients coming from high endemic regions.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/7. Endoscopic extraction of living fasciola hepatica: case report and literature review.fasciola hepatica infestation is known to cause bile duct inflammation and biliary obstruction. Endoscopic retrograde cholangiopancreatography shows distinct features in some patients with fascioliasis, but the condition may be overlooked in chronic cases. The endoscopic retrograde cholangiopancreatograpy images must be carefully examined to rule out other possible causes of irregularity and thickening of the common bile duct wall. Parasite removal during endoscopic retrograde cholangiopancreatograpy is one therapeutic option in patients with acute obstructive cholangitis due to F. hepatica. We present a case of fascioliasis-induced acute cholangitis that was diagnosed and treated via endoscopy. A review of the literature on extraction of living parasites is also included.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
4/7. Acute cholangitis after endoscopic sphincterotomy: complications of expectant treatment.Two elderly patients who had endoscopic sphincterotomy (EST) for their common duct stones developed acute cholangitis and, one of them also developed acute pancreatitis after the procedure. Despite the presence of an adequate sphincterotomy which allows subsequent spontaneous stone elimination, transient ductal obstruction during stone migration through the sectioned papilla is probably accountable for their complications. From the present reported experience, it is clear that expectant treatment of common duct stone after EST can be associated with definite hazards. Immediate biliary decompression with either active instrumental extraction or, when not feasible, insertion of nasobiliary catheter, should be performed to prevent these complications in selected patients.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/7. Obstructive jaundice and cholangitis due to choledocholithiasis: treatment by extracorporeal shock-wave lithotripsy.Endoscopic shock-wave lithotripsy, although now the standard treatment of urolithiasis, has only recently been applied to cholelithiasis. The authors describe the case of an 88-year-old man, a high-risk patient with choledocholithiasis, in whom endoscopic stone extraction after sphincterotomy failed. Extracorporeal shock-wave lithotripsy was used for noninvasive stone fragmentation and the fragments were passed without complication.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/7. ERCP and laparoscopic cholecystectomy for cholangitis in a 66-year-old male with situs inversus.A case report of the successful management of a patient with situs inversus viscerum and symptomatic choledocholithiasis and cholangitis is presented. The preoperative evaluation of the choledochus via ERCP and successful common bile duct stone extraction enabled successful laparoscopic cholecystectomy. The anatomic challenge of situs inversus viscerum mandates the selective use of intraoperative cholangiography during and upon completion of the laparoscopic cholecystectomy.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/7. Biliary ascariasis: report of a case.A 64-year-old female aborigine presented with acute cholangitis and obstructive jaundice for three days. Abdominal ultrasonography showed dilatation of the common bile duct, intrahepatic ducts and a linear tubular structure in the common bile duct. duodenoscopy showed a live Ascaris protruding through the papilla of Vater, which was retracted endoscopically. cholangitis improved dramatically after worm extraction and nasobiliary drainage. Endoscopic retrograde cholangiography revealed another worm retained in the common bile duct. It disappeared spontaneously from the common bile duct one week later. The barium study of the intestine showed multiple filling defects in the terminal ileum. A total of five worms passed into the stool after treatment with pyrantel pamoate.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |