Endoscopic Retrograde Cholangio-Pancreatographic Diagnosis and Extraction of Massive Biliary Ascariasis Presented with Acute Pancreatitis : A Case Report

VORAPHAN SAOWAROS, M.D.*

Affiliation : * Gastroenterology Unit, Department of Medicine, Police General Hospital, Bangkok 10330. Thailand.

AbstractThis paper reports the case of a young female Thai patient who presented with periodic severe abdominal pains which proved to be acute pancreatitis. Conventional investigations and treatments failed to prove and improve her condition. ERCP was done on the twelfth day after admission. 3 caudal ends of living round worms were noted protruding from the papillary orifice during endoscopy. Cholangiography revealed impacted multiple round worms in the common bile duct and both intrahepatic ducts. Endoscopic extraction of the worms was done by using dormia basket and removed with endoscope. Repeated procedure was done 21 times in two and a half hours, obtaining 26 live, mature Ascaris lumbricoides varying from 13 to 24 em in length. Repeated cholangiogram confirmed complete removal of the worms. The patient was relieved from abdo- minal pain immediately after the procedure, and given oral albendazole 400 mg daily for 7 days. She was discharged asymptomatic 8 days after Ascaris removal.

Keywords : ERCP, Massive Biliary Ascariasis, Acute Pancreatitis. Endoscopic Extraction

All Articles Download

Information

Related Links