The great escape of the round worm ( Ascaris lumbricoides)

Abstract

Ascariasis, the most widespread of human infections, is harboured by a population of 1.5 billion globally [ [1] Javid G. Wani N. Gulzar G.M. Javid O. Khan B. Shah A. Gallbladder ascariasis: presentation and management. Br J Surg. 1999; 86: 1526-1527 Crossref PubMed Scopus (29) Google Scholar ]. Biliary ascariasis, a result of inherent property of ascaroids to explore openings, accounts for 10–19% of Ascaris related admissions [ [2] Ochoa B. Surgical complications of ascariasis. World J Surg. 1991; 15: 222-227 Crossref PubMed Scopus (73) Google Scholar ]. Gallbladder (GB) ascariasis is occasionally seen even in endemic areas of ascariasis. The presence of Ascaris lumbricoides in the GB and bile duct can cause acute cholecystitis, acute cholangitis, biliary colics, acute pancreatitis and hepatic abscess [ [3] Khuroo M.S. Zargar S.A. Mahajan R. Hepatobiliary and pancreatic ascariasis in India. Lancet. 1990; 335: 1503-1506 Abstract PubMed Scopus (225) Google Scholar ]. In contrast to bile duct ascariasis, majority of patients having GB ascariasis need surgical treatment [ [1] Javid G. Wani N. Gulzar G.M. Javid O. Khan B. Shah A. Gallbladder ascariasis: presentation and management. Br J Surg. 1999; 86: 1526-1527 Crossref PubMed Scopus (29) Google Scholar ]. This is mainly due to the inability of the live worm to make an exit from the GB. Observing this act of exit by a live worm from the GB is very rare and thus deserves presentation.