Efficacy of ultrasound in diagnosis of patients with gallbladder, common bile duct and hepatic duct worms

Abstract

Ascariasis is confirmed to be more common in over populated rural societies with insufficient sewage and warm environments. We addressed the ultrasonic demonstration of biliary ascariasis and the worth of ultrasound in ratifying the diagnostics and assessment outcomes. In our study, 20 patients (8 females and 12 males) were included and conducted from Sep 2019 to Mar 2020 in the Saido Sharif hospital, SWAT, KPK, Pakistan. The criteria for including patients were based upon the ultrasonic findings expressing the biliary ascariasis such as non-shadowing curved or straight echoic structures like cords with or without central hypo-echoic tubes. The ultrasound follow-up was made in three consecutive interludes; 1 week subsequent to first ultrasonic diagnostics of all patients, 2 weeks after first treatment for 10 patients and 2 weeks after recurrent therapeutic treatment for 10 patients. There were 8 females and 12 males, including 3 pregnant patients (4, 5 and 6 months). Approximately 70% patients belong to the rural sides. The results of clinical laboratory exhibited higher level of leukocytosis in 85%, higher alkaline phosphatase in serum of 30% participants, irregular alanine aminotransferase level among 40%, and higher amylase in the serum of 10% patients. The sequential follow-up ultrasound was also made for diagnostics verification and evaluating the managing outcomes. After one week of initial ultrasound diagnosis, the 1st follow-up ultrasound was carried out to all the patients which revealed variation in the parasitic configuration and confirmed diagnosis in 14 cases. In 5 cases without any treatment, an impulsive exits of worms was reported from the biliary tree. In remaining 15 cases, the patients underwent multiple kinds of treatment. Six patients were cured using anthelminitic medications and four with surgical management. To conclude, Successive follow-up ultrasound proved to be very operational in ratifying the biliary worm’s diagnosis and has a significant function to assess the administrative outcomes. ​