Endoscopic Treatment of Biliary Ascariasis with a Common Bile Duct Stone: A case report.
- Author:
Il Gun CHUNG
;
Chang Seop KIM
;
Seung Joon KIM
;
Ki Won OH
;
Jae Kwang KIM
;
Sung Hoon KIM
;
In Sik CHUNG
- Publication Type:Original Article
- Keywords:
Biliary ascaris;
CBD stone;
Endoscopic treatment
- MeSH:
Abdominal Pain;
Acoustics;
Adult;
Ascariasis*;
Ascaris;
Bile;
Bile Ducts;
Bile Ducts, Intrahepatic;
Cholangiopancreatography, Endoscopic Retrograde;
Cholangitis;
Cholecystitis;
Choledocholithiasis;
Colic;
Common Bile Duct*;
Female;
Hemobilia;
Humans;
Lithotripsy;
Liver;
Middle Aged;
Shadowing (Histology);
Surgical Instruments;
Therapeutic Irrigation
- From:Korean Journal of Gastrointestinal Endoscopy
1993;13(3):573-576
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Biliary ascariasis is a rare complication of intestinal ascaris infestation. Retrograde migration of the adult worm through the papilla of Vater causes biliary colic, and may give rise to pancreatic and biliary obstruction, choledocholithiasis, cholecystitis, cholangitis, hemobilia, and if the worm lodges in intrahepatic bile ducts, to liver absceases. In the past, treatment of biliary ascariasis has usually involved the direct removal of ascaris throagh a surgical choledochatomy and subsequent saline lavage of the common duct through an indwelling T tube. Recently, the worm in the bile duct can be seen by ERCP and it can be removed during the endoscopic procedure. A 55-year-old woman with intermittent colicky right upper quadrant abdominal pain was admitted to out hospital. Abdominai sonogram disclosed an echogenic structure within a mildly dilated common bile duct and a high ehogenic structure with acoustic shadowing in the distal common bile duct(CBD), which suggests a CBD stone. ERCP after obtaining the sonogram revealed a thick, long, linear, smooth filling defect in the CBD with a distal CBD stone. A distal CBD stone was removed by sphinctetotomy and lithotripsy, then we directly extracted ascaris with a tripod forcep without any complication.
