CASE 474 Published on 23.05.2000

Biliary ascariasis

Section

Abdominal imaging

Case Type

Clinical Cases

Authors

F. Jelavic-Kojic , G. Simac-Kubat , Z. Sucic , *B. Bakula , *T. Anic

Patient

71 years, female

Imaging Findings
The patient lived in northern Croatia. An ultrasound examination diagnosed chronic calculous cholecystitis and choledocholithiasis. An open cholecystectomy and choledocotomy with extraction of common bile duct stones was performed. With the patient feeling well, a T-Tube cholangiogram was performed on the 9th postoperative day.
Discussion
Ascariasis is a well known cause of ac. cholecystitis and cholangitis (1). The diagnosis is often considered when patients with biliary pain come from an area of high prevalence of ascariasis (2,3)although choledocholithiasis alone may be difficult to differentiate from it by ultrasonography(4). In this patient the post-operative cholangiogram demonstrated 2 tubular filling defects, one apparently extruding through the papilla and the other extending into the left hepatic duct. No evidence of worms were seen at surgery, and this therefore represents an incidental postoperative finding(5). The patient was given a 5 day course of Mebendazol and discharged from hospital on the 18th postoperative day after a repeat negative cholangiogram.
Differential Diagnosis List
CBD and left hepatic duct ascariasis
Final Diagnosis
CBD and left hepatic duct ascariasis
Case information
URL: https://eurorad.org/case/474
DOI: 10.1594/EURORAD/CASE.474
ISSN: 1563-4086