Ascaris into common bile duct

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An Ascaris went up in CBD of a 38yo female patient for 4 days which made her vomiting and epigastric pain. Ultrasound detected it and the worm was removed still alive by E R C P.

Transcript of Ascaris into common bile duct

  • 1.ASCARIS into COMMON BILE DUCT CASE REPORT Dr PHAN THANH HAI MEDIC MEDICAL CENTER, HCMC, VIETNAM

2. STORY

  • A 38YO WOMAN WENT THROUGH ANACUTE EPIGASTRIC PAIN AND VOMITING FOR 4 DAYS.
  • ABDOMINAL ULTRASOUND DETECTED ABIG GALL-BLADDER WITHOUT STONE, AND COMMON BILE DUCT (CBD) DILATED OF 1,5CM, WITHTUBULAR ECHOGENIC STRUCTURE INSIDE, NO SHADOWING LOOK LIKE AN ASCARIS WHICH WAS STILL ALIVE.
  • ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)PRESENTED A WORM INTO CBD THROUGHTHE PAPILLA AND EXTRACTING ITBY SNAKE. ABDOMINAL SYMPTOMS HAS RESOLVED AND THE PATIENT REMAINS WELL WITHOUT SIGN OF CHOLANGITIS.
  • AN ASCARIS STILL MOVES WEAKLY WHEN BEING OUT FROM CBD. BECAUSE HAVING A VULVAR WAIST AND NOT A HOOK AT ITS POSTERIOR, IT IS A FEMALE ADULT WORM.
  • WHY DOES AN ADULT ASCARIS MOVE UP TO AN ECTOPIC PLACE (COMMON BILE DUCTINSTEAD OF JEJUNUM) ?

3. ABDOMINAL ULTRASOUND DETECTED ABIG GALL-BLADDER WITHOUT STONE, AND COMMON BILE DUCT DILATED OF 1,5CM, WITHTUBULAR ECHOGENIC STRUCTURE INSIDE, NO SHADOWING. A: Longitudinal section; B: Transversal section 4. 5. ERCP presented a worm being in CBD and at the papilla, then extracting it out . 6. 7. The female ascaris (because it has a vulvar waist) after removing from CBD still moving weakly.