Abstract

YEPES, Nora Luz; SANIN, Eugenio  and  SEPULVEDA, María Elsy. Ascaridiasis biliar: manejo endoscópico. Rev Col Gastroenterol [online]. 2003, vol.18, n.2, pp.83-87. ISSN 0120-9957.

Objectives. This study presents eight cases of hepatobiliary complications of ascariasis in four children and four adults. The authors describe the clinical, laboratory, and imaging findings, as well as the patients’ clinical evolution. Methods.These cases were studied within a period of approximately one year and included children 19, 22, 50 and 97 months old, and four adults 47, 49, 52 and 59 years old. The authors reviewed their medical history and evaluated the results of their main diagnostic examinations. Results. All of the patients had vomiting, abdominal pain, pallor, and abdominal distension at presentation. Passage of Ascaris lumbricoides in stool occurred in two cases, emesis with worms in three, fever and hepatomegaly in two. No patients had Ascaris lumbricoides present in the pancreatic duct. One adult patient had hepatic abscess, and one of them also had cholangitis. In one child (19 months old) we left a nasobiliary drain for direct administration of piperazine. Conclusions. Ultrasonography was the imaging diagnostic method of choice and demonstrated the presence of Ascaris lumbricoides in the biliary ducts, as well as signs of hepatic abscess. Endoscopic retrograde cholangiopancreatography used to confirm the diagnosis, was a fundamental procedure in the treatment, allowing the removal of worms from the biliary duct in six of seven patients or the direct administration to the biliary tree of piperazine through nasobiliary drain. In a patient the parasite was retired with a frontal view endoscope.

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