Biliary ascariasis--a worm in the duct
Kolt, S.D.; Wirth, P.D.; Speer, A.G.
Medical Journal of Australia 154(9): 629-630
1991
ISSN/ISBN: 0025-729X PMID: 2056950 Document Number: 384859
This is the first report of biliary obstruction, due to Ascaris lumbricoides, in a patient in Australia. A 62-year-old Vietnamese woman who had migrated to Australia one month previously, presented with a 24-h history of right upper quadrant pain, fever and vomiting. Ultrasound demonstrated cholelithiasis but the common bile duct was not dilated. She underwent cholecystectomy. 24-h after surgery she vomited an A. lumbricoides and became febrile. Repeat ultrasound showed an 8 mm dilated common bile duct. Treatment with mebendazole was begun on the 3rd postoperative day, and a live roundworm was removed from the stomach on the 5th postoperative day. Reexamination of the operative cholangiogram led to the appreciation of a linear filling defect in the common bile duct, and a dead Ascaris (13 cm long) was extracted from the bile duct.