Document Detail


Clinical features and management of biliary ascariasis in a non-endemic area.
MedLine Citation:
PMID:  10622777     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Biliary ascariasis is common in certain geographical areas of the world. In India, it is common in the Kashmir valley and only stray cases have been reported from other parts of the country. Between January 1995 and May 1997, 14 patients with biliary ascariasis were seen at our centre, which is more than 1000 km from the Kashmir valley. The mean (+/- SD) age of the patients was 31.7 (+/- 6.1) years and all were females. None of them had been to a place known to be endemic for biliary ascariasis. Four patients presented with acute cholangitis, eight with acute abdominal pain and vomiting, and the remaining two were diagnosed incidentally during surgery for gallstone disease. Barring these two patients, ultrasound examination of the abdomen diagnosed the condition accurately. In 10 patients, a part of the worm was visible outside the papilla of Vater. The roundworm was caught in a Dormia basket and could be extracted in nine patients. In one patient the worm migrated inside the bile duct while it was being caught in a Dormia basket. In this and two other patients, in whom the worm had migrated completely inside the bile duct, worms were removed with the help of a Dormia basket after endoscopic sphincterotomy. There were no complications of endoscopic therapy. In the two patients in whom biliary ascariasis was detected during surgery, the worms were removed after choledocholithotomy. On a mean follow-up of 13.8 months, only one patient had a recurrence of biliary ascariasis. It is concluded that biliary ascariasis is not an uncommon disease and must be considered as a possibility in patients presenting with acute cholangitis and biliary pain even in a non-endemic area. Ultrasonography is an excellent diagnostic tool and endoscopic management is very effective and safe in the treatment of these patients.
Authors:
S P Misra; M Dwivedi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Postgraduate medical journal     Volume:  76     ISSN:  0032-5473     ISO Abbreviation:  Postgrad Med J     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-05-11     Completed Date:  2000-05-11     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0234135     Medline TA:  Postgrad Med J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  29-32     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, MLN Medical College, Allahabad 211 001, India.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / parasitology,  ultrasonography
Adolescent
Adult
Animals
Ascariasis / complications*,  ultrasonography
Ascaris lumbricoides*
Bile Duct Diseases / parasitology*,  ultrasonography
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis / parasitology,  ultrasonography
Female
Humans
Middle Aged
Recurrence
Sphincterotomy, Endoscopic
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