1/16. Bilo-pancreatic ascaris lumbricoides infestation. Endoscopic discovery and removal.ascaris lumbricoides infestation is relatively rare in industrialized countries, and it occurs mainly in conditions in which hygiene is lacking. We describe here a case of a 39-year-old female from ex-Jugoslavia affected by recurrent hepatic colic. At entry ultrasonography revealed microlithiasis in the gallbladder and widening of the pancreatic head. The subsequent ERCP showed slight filling defects in the choledochus and an inflammation-like stricture of the papilla of Vater, and after endoscopic sphincterotomy we saw an outflow of dense bile and microlitholits. Thus, a standard surgical cholecystectomy was carried out and the patient was dismissed on the 3rd postoperative day without any symptoms. However, the patient was admitted again after four days for a new coliky pain attack. An upper endoscopy showed a 23 cm long mobile parasite in the duodenum: it was caught with the polypectomy loap, extracted and identified as A. Lumbricoides. The patient's symptoms disappeared after the endoscopic removal of the worm and she was dismissed the day after the worm's removal. No recurrence of symptoms was noted during a 1-year follow-up. This case showed that A. Lumbricoides infestation of the biliary tree should be considered when biliary and/or pancreatic symptoms recur, especially in patients coming from undeveloped countries. At the same time we showed that endoscopic removal is a safe and effective treatment for this infestation.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/16. pancreatitis with gallbladder ascariasis in a child: case report.A 10-year-old girl was admitted for abdominal pain for 1 week. Morning vomiting with 5 Ascaris and diarrhea with Ascaris were found. Radiograph of the abdomen disclosed no significant abnormality. Abdominal sonogram revealed a normal biliary tree; but mildly enlarged pancreatic thickness, and thickened gallbladder wall. Within the thickened gallbladder wall a linear echogenic structure with worm-like movement suspected of being Ascaris was found. We report this case because pediatric pancreatitis and a gallbladder wall thickened with worm-movement have rarely been reported. Urgent treatment and surgery are required for the very ill child with a tensely distended abdomen or signs of peritoneal irritation. early diagnosis is very important to prevent further complications. We emphasize the role of sonography in the diagnosis of this case and the prevention of progressive deterioration.- - - - - - - - - - ranking = 7keywords = gallbladder (Clic here for more details about this article) |
3/16. Sonographic diagnosis of Ascaris-induced cholecystitis and pancreatitis in a child.We describe the sonographic diagnosis of Ascaris-induced acute cholecystitis and pancreatitis in a 2-year-old girl. Abdominal sonography revealed a grossly distended gallbladder with a thick (0.5-cm) wall. The common bile duct was dilated to 0.6 cm without sludge or calculi. The pancreas was hypoechoic, with an enlarged, 3.3-cm pancreatic head. Sonography showed dilatation of the small- and large-bowel loops, with multiple roundworms in duodenal and colonic loops. Sonography has an important role not only in the diagnosis of this uncommon condition but also in the documentation of its unusual etiologic agent.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
4/16. ascariasis-induced empyema of gallbladder: report of a case.A rare case of a 52-year-old woman with empyema of the gallbladder due to ascariasis causing an obstruction in the cystic duct is presented. She was admitted on September 20, 2000, and on September 23 an emergency cholecystectomy was performed. ultrasonography is a highly sensitive and specific method for diagnosing gallbladder ascariasis, and a cholecystectomy is considered mandatory for the treatment of empyema of the gallbladder.- - - - - - - - - - ranking = 7keywords = gallbladder (Clic here for more details about this article) |
5/16. Successful elimination of ascaris lumbricoides from the gallbladder by conservative medical therapy.Migration of ascaris lumbricoides into the gallbladder is rare, unlike ascariasis of the bile duct, and, when it does occur, treatment is generally by endoscopic or surgical extraction. We describe a case of the successful treatment of gallbladder ascariasis with conservative therapy. A 44-year-old Korean man was admitted because of nausea and right upper quadrant pain that did not respond to medical control and had worsened 1 day before admission. Abdominal ultrasonography showed a long, linear, moving echogenic structure in the distended lumen of the gallbladder, but no abnormal dilation of the bile duct. Computerized tomography showed a linear soft-tissue density in the dependent portion of the gallbladder. The patient presented with eosinophilia, and abnormal liver function results, but no fever or hepatomegaly. Based on these findings, and presuming a diagnosis of gallbladder ascariasis, we administered antiparasitic medication (albendazole 400 mg/day for 1 day). Seven days later, we obtained one adult female A. lumbricoides from the feces. The symptoms were fully resolved, and no moving structure could be visualized in the gallbladder by ultrasonography. We recommend that initial therapy for gallbladder ascariasis should involve conservative treatment, unless an associated disease is present or a complication arises.- - - - - - - - - - ranking = 11keywords = gallbladder (Clic here for more details about this article) |
6/16. Ascaris in gallbladder: report of a case and review.A case of an Ascaris infection of the gallbladder is reported in a 29 years old female. The biological check-up was normal. The diagnosis was confirmed by ultrasonography and the patient was cured by albendazole. Such a localization is uncommon (2.1% of the hepatobiliary ascariasis), and the abdominal ultrasonography is the best way to confirm the diagnosis. albendazole is the current treatment, but cholecystectomy is sometimes a must.- - - - - - - - - - ranking = 5keywords = gallbladder (Clic here for more details about this article) |
7/16. Recurrent cholangitis secondary to oriental cholangiohepatitis.A Korean woman with a known mass in the left lobe of the liver and a normal gallbladder by ultrasound suffered recurrent cholangitis, which ultimately proved to be Oriental cholangiohepatitis. This disease, endemic to East asia, has become widespread in the united states as immigration from that area has increased. The symptoms are identical to recurrent cholangitis associated with gallstones, but the natural history and definitive treatment are entirely different. The diagnosis should be suspected in patients with a history of parasitic infestation with ascaris lumbricoides or clonorchis sinensis or in those who have lived in an endemic area.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
8/16. Endoscopic diagnosis and extraction of biliary ascaris.A woman was admitted to hospital after several episodes of severe upper right abdominal pain and vomiting. Previously she had had cholecystectomy for gallbladder stones, and later endoscopic papillotomy to treat common duct stone. Endoscopic retrograde cholangiography diagnosed an Ascaris worm in the common bile duct. One end of the 20 cm long living worm was caught in a Dormia basket when it protruded through the papillotomy opening, and the worm extracted with the endoscope.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
9/16. Fatal human ascariasis following secondary massive infection.More than 796 ascaris lumbricoides worms weighing 550 g were recovered at autopsy from a 2-year-old black South African girl. Most of the worms were taken from necrotic small intestine, but worms were also in the stomach, esophagus, intrahepatic and extrahepatic bile ducts, and gallbladder. The worms had caused torsion and gangrene of the ileum, which was interpreted as the cause of death. Worms were formalin-fixed and individually weighed. There were 796 intact worms and 112 appreciably large (greater than 0.2 g) fragments of worms. Statistical analysis of the weights revealed 2 distinct populations of worms: 16 large worms (0.5-2.3 g) and 778 small worms (0.03-0.95 g). The difference in weight between these 2 groups of worms was significant (male and female worms treated separately; P less than 0.05 to P less than 0.001). These observations reveal that the patient acquired a massive and fatal infection with A. lumbricoides while hosting a relatively burden.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
10/16. ascariasis of the gallbladder: report of two cases and review of the literature.ascariasis of the gallbladder, unlike ascariasis of the bile duct, is a rare entity. The authors add two cases to the 39 already reported in the literature, and discuss the clinical features, diagnosis and management of this condition.- - - - - - - - - - ranking = 5keywords = gallbladder (Clic here for more details about this article) |
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