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Intrahepatic Duct Stones Harboring Ascariasis Ova

View Article: PubMed Central - PubMed

ABSTRACT

Ascariasis lumbricoides is one of the most common helminthic infestations in humans. Despite the fact that the prevalence of ascariasis in developed countries has been decreasing, biliary ascariasis can cause serious complications, such as acute cholangitis, pancreatitis, and liver abscess. Here we presented a rare ascariasis-related complication—hepatolithiasis.

A 60-year-old female patient had symptoms of recurrent cholangitis. Abdominal computed tomography scan revealed left intrahepatic duct stones with left liver lobe atrophy. Endoscopic retrograde cholangiopancreatography was performed, but the stones could not be removed due to left main intrahepatic duct stenosis. The patient was treated with left hemi-hepatectomy. Unexpectedly, Ascaris ova were found on the histopathological examination. She received antihelminthic therapy orally and was on regular follow-up without any complications.

Our study indicates that clinicians should be aware of biliary ascariasis in patients with hepatolithiasis, though not living in endemic areas.

No MeSH data available.


Related in: MedlinePlus

A, Computed tomography (CT) scan showed left liver atrophy with IHD stones and biliary dilatation. The configuration of contralateral lobe was normal without obvious lesions. B, ERCP showed left main IHD stenosis over hilar area with stones in left hepatic lobe. Common bile duct was dilated, whereas right intrahepatic ducts remained intact. ERCP = endoscopic retrograde cholangiopancreatography, IHD = intrahepatic duct.
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Figure 1: A, Computed tomography (CT) scan showed left liver atrophy with IHD stones and biliary dilatation. The configuration of contralateral lobe was normal without obvious lesions. B, ERCP showed left main IHD stenosis over hilar area with stones in left hepatic lobe. Common bile duct was dilated, whereas right intrahepatic ducts remained intact. ERCP = endoscopic retrograde cholangiopancreatography, IHD = intrahepatic duct.

Mentions: A 60-year-old female patient presented with right hypochondrial dull pain radiating to the back and upper shoulders bilaterally. She had been living and working at a farm in rural area since the age of 15 without special traveling history. There was a history of increased frequency of intermittent abdominal pain and occasional fever for at least 2 years. The patient looked ill, poorly nourished, but no jaundice; physical examination revealed right upper abdominal tenderness, but no rebounding pain. Vital signs were within normal limits. Blood tests were as follows: hemoglobin 9.2 g/dL, hematocrit level 29.4%, alkaline phosphatase 112 U/L, whereas the white blood cell count, serum amylase level, and the remaining liver function tests were within normal limits. The stool microscopic examination was negative. Abdominal computed tomography (CT) scan revealed left intrahepatic duct (IHD) stones with atrophy of left lobe of liver (Figure 1A), whereas endoscopic retrograde cholangiopancreatography (ERCP) could not remove the stones due to left main IHD stenosis (Figure 1B).


Intrahepatic Duct Stones Harboring Ascariasis Ova
A, Computed tomography (CT) scan showed left liver atrophy with IHD stones and biliary dilatation. The configuration of contralateral lobe was normal without obvious lesions. B, ERCP showed left main IHD stenosis over hilar area with stones in left hepatic lobe. Common bile duct was dilated, whereas right intrahepatic ducts remained intact. ERCP = endoscopic retrograde cholangiopancreatography, IHD = intrahepatic duct.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998388&req=5

Figure 1: A, Computed tomography (CT) scan showed left liver atrophy with IHD stones and biliary dilatation. The configuration of contralateral lobe was normal without obvious lesions. B, ERCP showed left main IHD stenosis over hilar area with stones in left hepatic lobe. Common bile duct was dilated, whereas right intrahepatic ducts remained intact. ERCP = endoscopic retrograde cholangiopancreatography, IHD = intrahepatic duct.
Mentions: A 60-year-old female patient presented with right hypochondrial dull pain radiating to the back and upper shoulders bilaterally. She had been living and working at a farm in rural area since the age of 15 without special traveling history. There was a history of increased frequency of intermittent abdominal pain and occasional fever for at least 2 years. The patient looked ill, poorly nourished, but no jaundice; physical examination revealed right upper abdominal tenderness, but no rebounding pain. Vital signs were within normal limits. Blood tests were as follows: hemoglobin 9.2 g/dL, hematocrit level 29.4%, alkaline phosphatase 112 U/L, whereas the white blood cell count, serum amylase level, and the remaining liver function tests were within normal limits. The stool microscopic examination was negative. Abdominal computed tomography (CT) scan revealed left intrahepatic duct (IHD) stones with atrophy of left lobe of liver (Figure 1A), whereas endoscopic retrograde cholangiopancreatography (ERCP) could not remove the stones due to left main IHD stenosis (Figure 1B).

View Article: PubMed Central - PubMed

ABSTRACT

Ascariasis lumbricoides is one of the most common helminthic infestations in humans. Despite the fact that the prevalence of ascariasis in developed countries has been decreasing, biliary ascariasis can cause serious complications, such as acute cholangitis, pancreatitis, and liver abscess. Here we presented a rare ascariasis-related complication—hepatolithiasis.

A 60-year-old female patient had symptoms of recurrent cholangitis. Abdominal computed tomography scan revealed left intrahepatic duct stones with left liver lobe atrophy. Endoscopic retrograde cholangiopancreatography was performed, but the stones could not be removed due to left main intrahepatic duct stenosis. The patient was treated with left hemi-hepatectomy. Unexpectedly, Ascaris ova were found on the histopathological examination. She received antihelminthic therapy orally and was on regular follow-up without any complications.

Our study indicates that clinicians should be aware of biliary ascariasis in patients with hepatolithiasis, though not living in endemic areas.

No MeSH data available.


Related in: MedlinePlus