| A case of common bile duct ascariasis diagnosed by duodenoscopy is presented. At the admission, the patient, cholecystectomized for gallstones 13 years before, had been complaining of epigastric pain associated with post-prandial and nocturnal vomiting. physical examination showed only slight tenderness in the epigastrium. Laboratory findings were within normal limits, with the exception of a moderate leukocytosis. Intravenous cholangiography showed the lack of visualization of the terminal common bile duct, but the flow of contrast medium was normal. duodenoscopy, carried out without a specific clinical suspicion, revealed an ascaris lumbricoides inserted in the common bile duct and partially protruding from the papilla Vateri. The patient was treated by piperazine, intravenous fluids, antibiotics and a choleretic compound. After 24 hours an ascaris 33 cm long was excreted in the faeces and the patient became symptom-free. Some pathophysiological, clinical and epidemiological aspects of biliary ascariasis are discussed. ( info) |
| A case with association of congenital cystic dilatation of the common bile duct and congenital diverticulum of the hepatic duct is reported. The etiology and classification are briefly discussed and a radiological approach is recommended. ( info) |
| We described a patient with encephalopathy associated with visceral larva migrans (VLM) caused by ascaris suum. He suffered from drowsiness, quadriparesis, eosinophilia and elevated serum IgE levels. brain magnetic resonance (MR) imaging revealed multiple cerebral cortical and white matter lesions. Serological tests indicated recent infection with A. suum. pulse steroid therapy relieved the patient's central nervous system symptoms and marked improvement of lesions on brain MR images. We concluded that the encephalopathy in this patient was probably caused by VLM due to ascaris suum. ( info) |
4/186. Endoscopic retrograde cholangio-pancreatographic diagnosis and extraction of massive biliary ascariasis presented with acute pancreatitis: a case report. This 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 cm in length. Repeated cholangiogram confirmed complete removal of the worms. The patient was relieved from abdominal pain immediately after the procedure, and given oral albendazole 400 mg daily for 7 days. She was discharged asymptomatic 8 days after Ascaris removal. ( info) |
5/186. Biliary ascariasis: CT, MR cholangiopancreatography, and navigator endoscopic appearance--report of a case of acute biliary obstruction. A case of acute common bile duct obstruction caused by a roundworm in a 6-year-old girl is reported. Computed tomography (CT) and magnetic resonance imaging (MRI) showed "bull's-eye" and "eye-glass" appearances of the ascaris in the common bile duct. On reformation of the transverse CT and coronal MR images, the tubular Ascaris was better depicted. MRI and navigator endoscopic demonstrations of the common bile duct ascaris have not been described previously in the literature. These CT and MRI findings may be helpful in the diagnosis of Ascaris. ( info) |
| We describe a case of relapsing pneumothorax occurring in a male child aged 11 yrs, resulting from the mechanical inflammatory action of ascaris lumbricoides larvae localized in the pleuropulmonary tissue. Pulmonary ascariasis should still be considered today in the differential diagnosis of spontaneous pneumothorax occurring in children. ( info) |
| ascaris lumbricoides, roundworm, is a Nematode parasite infecting about 1 billion people worldwide. We report the case of a ten-year-old Bedouin girl hospitalized with burns to 45% of her body surface area, including the face. The patient was intubated upon admission and mechanically ventilated. Four days later she was extubated but required reintubation 15 min later for severe hypoxemia. laryngoscopy disclosed an unidentified tube which obstructed the opening of the larynx. The 'tube' was removed by Magill forceps. The object was identified as a 35 cm long Ascaris roundworm. Once the worm was removed the patients' respiratory condition dramatically improved. We review the main features of Ascaris infection and some similar cases of airway obstruction caused by this worm. ( info) |
8/186. A rare cause of biliary pain in belgium. ascaris lumbricoides is the most frequent human helminthic parasite. Usually human ascariasis is poorly symptomatic but complications can arise due to worm migration. Erratic worm migration into the biliary tree is a rare but threatening condition regarding the associated complications: cholecystitis, pancreatitis, obstruction of bile ducts, liver abcesses and recurrent pyogenic cholangitis. We describe a case of a young belgian women suffering from recurrent biliary colics over a period of eight months with repeated normal ultrasound findings. ERCP proved being the only effective diagnostic procedure for a living biliary worm, which was successfully removed with a balloon catheter. ( info) |
9/186. Radiologic-pathologic findings in raccoon roundworm (Baylisascaris procyonis) encephalitis. A 13-month-old boy developed eosinophilic meningoencephalitis, retinitis, and a protracted encephalopathy with severe residual deficits. The initial MR examination revealed diffuse periventricular white matter disease, and follow-up images showed atrophy. brain biopsy, serology, and epidemiologic studies lead to the diagnosis of Baylisascaris procyonis infection, a parasitic disease contracted through exposure to soil contaminated by the eggs of a common raccoon intestinal roundworm. The pathologic, epidemiologic, and imaging features of this disease are herein reviewed. ( info) |
10/186. Abnormal migration of ascaris into the middle ear. Ascaris in the middle ear is very rare with very few cases having been reported. We report here two such cases with different presentations. ( info) |