Ascaris Lumbricoides as a Cause of Obstructive Jaundice. When the Nematode Outdoues Fiction

Abstract

Listen

Translate article

Lumbricoid ascariasis, is the most common helminth in humans.It is a cylindrical worm, humans acquires it by ingesting its eggs, which is found in contaminated areas. It is initially housed in the duodenum and small intestine, from where it can reach other sites. Such as the bile duct, where it can cause bile duct obstruction. Since its frequency is relatively low, we present a case of obstructive jaundice due to ascariasis. The patient, a Female of 15 years, begins with sudden pain in the right hypochondrium, as well as changes in coloration in teguments until reaching jaundice,Managed medically without improvement,she was sent to our unit. Upon with septic shock, pain in the right hypochondrium, with no evidence of peritoneal irritation. Biliary USG, with intrahepatic dilatation of BD, as well as double rail image in bile duct. CT scan with a bile duct in the intrapancreatic portion, as well as an elongated, hyperdense tubular image. ERCP is performed, finding dilated bile duct of with filling defects in distal parth compatible with stones and a long filling defect suggestive of ascariasis, a wide sphincterotomy was performed, and several small stones of approx. 5 to 10 mm, two of 12 mm and an adult Ascaris were removed. 72 hours later laparoscopic cholecystectomy is performed without eventualities, and patient was discharged the next day. Biliary ascariasis is an entity that represents 3.5% of the causes of jaundice, however it should be suspected in entities where the prevalence of the nematode is high.