Document Detail

Pancreatic-biliary ascariasis: experience of 300 cases.
MedLine Citation:
PMID:  9399767     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Infestation with Ascaris lumbricoides is seen worldwide. Recently, there has been much interest in the pancreatic-biliary complications of Ascaris infection. In this study, we present our experience of 300 patients seen in a tertiary referral center. MATERIALS AND METHODS: Case charts of patients seen in the Department of Gastroenterology, University of Damascus, Syria, were analyzed, retrospectively, over a 5-yr period (September of 1988 to August of 1993). During this period, 1666 endoscopic retrograde cholangiopancreatographic studies were performed and pancreatic-biliary ascariasis was diagnosed in 300 patients (18%). RESULTS: The most common presenting symptom was abdominal pain, seen in 98% of patients (294 patients). Complications observed were ascending cholangitis (48 patients; 16%), acute pancreatitis (13 patients; 4.3%), and obstructive jaundice (4 patients; 1.3%). History of worm emesis was present in 25% of patients (76 patients). Most patients (240 patients; 80%) had previously undergone a cholecystectomy or an endoscopic sphincterotomy (232 patients; 77%). Worms were successfully extracted endoscopically in all except two patients, and there were no procedure-related complications. CONCLUSIONS: In endemic countries, ascariasis should be suspected in patients with pancreatic-biliary disease, especially if a cholecystectomy or sphincterotomy has been performed in the past. Endoscopic management results in rapid resolution of symptoms and prevents development of complications.
F Sandouk; S Haffar; M M Zada; D Y Graham; B S Anand
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  92     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1997-12-29     Completed Date:  1997-12-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2264-7     Citation Subset:  IM    
Department of Gastroenterology, The University of Damascus, School of Medicine, and Al-Mouassat University Hospital, Syria.
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MeSH Terms
Abdominal Pain / parasitology
Acute Disease
Aged, 80 and over
Ampulla of Vater / parasitology
Ascariasis / diagnosis*,  surgery
Biliary Tract Diseases / diagnosis,  parasitology*,  surgery
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis / parasitology
Cholestasis / parasitology
Common Bile Duct Diseases / parasitology
Dilatation, Pathologic / parasitology
Endemic Diseases
Middle Aged
Pancreatic Diseases / diagnosis,  parasitology*,  surgery
Pancreatic Ducts / parasitology
Pancreatitis / parasitology
Retrospective Studies
Sphincterotomy, Endoscopic
Vomiting / parasitology

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