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Sonography of biliary worms (ascariasis)

Sonography of biliary worms (ascariasis) Andre Schulman, MB, Trevor Roman,MB, Rhidian Dalrymple, MB, Shadley Fataar, MB, and Patrick Morton, MB Case Report A 19-yr-old woman experienced severe colicky pain in the right upper quadrant of the abdomen for three days with radiation to the back. She had suffered several similar episodes over the last three years, on one occasion vomited worms. Although biliary ascariasis was therefore previously suspected, the diagnosis was never confirmed. She had a temperature of 38C and was markedly tender in the epigastrium and right upper quadrant. Liver function tests, serum amylase, amebic latex fixation test, plain abdominal radiograph, intravenous urogram, and urinalysis were entirely normal. Ultrasound examination showed a long, thin, linear echo without distal acoustic shadowing in the main bile duct (Fig 1).Otherwise, bile ducts, gallbladder, and liver appeared normal. Intravenous cholangiography on the same day revealed the typical and diagnostic appearance of Ascaris roundworm in the main bile duct (Fig 2). As the pain recurred following a course of piperazine and mebendazole, endoscopy with a view to removal of the worm from the main bile duct was performed. At this time however, the only abnormality found was a patulous and graular Vater's papilla. No worm was seen http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Clinical Ultrasound Wiley

Sonography of biliary worms (ascariasis)

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References (9)

Publisher
Wiley
Copyright
Copyright © 1982 Wiley Periodicals, Inc., A Wiley Company
ISSN
0091-2751
eISSN
1097-0096
DOI
10.1002/jcu.1870100208
Publisher site
See Article on Publisher Site

Abstract

Andre Schulman, MB, Trevor Roman,MB, Rhidian Dalrymple, MB, Shadley Fataar, MB, and Patrick Morton, MB Case Report A 19-yr-old woman experienced severe colicky pain in the right upper quadrant of the abdomen for three days with radiation to the back. She had suffered several similar episodes over the last three years, on one occasion vomited worms. Although biliary ascariasis was therefore previously suspected, the diagnosis was never confirmed. She had a temperature of 38C and was markedly tender in the epigastrium and right upper quadrant. Liver function tests, serum amylase, amebic latex fixation test, plain abdominal radiograph, intravenous urogram, and urinalysis were entirely normal. Ultrasound examination showed a long, thin, linear echo without distal acoustic shadowing in the main bile duct (Fig 1).Otherwise, bile ducts, gallbladder, and liver appeared normal. Intravenous cholangiography on the same day revealed the typical and diagnostic appearance of Ascaris roundworm in the main bile duct (Fig 2). As the pain recurred following a course of piperazine and mebendazole, endoscopy with a view to removal of the worm from the main bile duct was performed. At this time however, the only abnormality found was a patulous and graular Vater's papilla. No worm was seen

Journal

Journal of Clinical Ultrasound – Wiley

Published: Feb 1, 1982

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