biliary ascaris

MRI and MRCP confirmed multiple intrahepatic abscesses, bilobar intrahepatic biliary dilation, and a dilated proximal CBD (Figures 3 and 4). A linear tubular structure with central hyperintensity was seen in the proximal CBD. On axial MRI, a “bull’s-eye” appearance suggestive of ascariasis was seen (Figure 3B). The right and left hepatic ducts also showed similar tubular linear defects. A markedly hypointense rounded focus with central hyperintensity was seen in the proximal CBD distal to the worm with a normal distal CBD, which was suggestive of choledocholithiasis (Figure 4). The gallbladder showed multiple markedly hypointense foci due to cholelithiasis, along with a few less hypointense foci caused by ascariasis (Figure 5).

The patient’s condition improved after antihelminthic therapy with albendazole and Antibiotics was initiated.

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A screening, bed side Ultrasound scan was carried out by the Emergency Physician. It revealed a hyper-echoic, tubular, elongated structure in the region of the porta hepatis with what seemed to be a dilated common bile duct (CBD) (Figure 1). At this stage, the patient was questioned for a past surgical or interventional history, which he denied, but he did give a history of passing large worms in his stool 10-12 years before.

The patient was then sent to the radiology department for a formal ultrasound scan, which confirmed the diagnosis of round worm infestation of a dilated CBD (Figure 2).



http://www.hmc.org.qa/mejem/mar2003/cr/41.htm

biliary parasites


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biliary parasites


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http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2007;volume=13;is...




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