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Korean J Gastrointest Endosc > Volume 42(6); 2011 > Article
Korean Journal of Gastrointestinal Endoscopy 2011;42(6): 442-445.
A Case of Biliary Ascariasis with Duodenal Stenosis
Kang Jin Park, M.D., Cho Yun Chung, M.D., Young A Song, M.D., Sang Hun Kim, M.D., Chung Su Park, M.D., Sung Bum Cho, M.D., Wan Sik Lee, M.D. and Young Eun Joo, M.D.
Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
Abstract
Infestation with Ascaris lumbricoides is one of the most common helminthic diseases in humans. The highly motile mature worm can cause intestinal obstructions, pancreaticobiliary diseases, appendicitis, and peritonitis. However, biliary ascariasis associated with duodenal stenosis is extremely rare. We report a case of biliary ascariasis with duodenal stenosis in a 70-year-old man. The patient was admitted to our hospital with a 2 month history of epigastric pain and vomiting. An esophagogastroduodenoscopy showed stenosis of the second portion of the duodenum and an impacted living round worm in the ampulla of Vater. The round worm was extracted with a snare without any complications, and the patient received albendazole treatment. A pathological examination of the stenotic portion of the biopsy specimen revealed chronic inflammation with eosinophilic infiltration throughout the mucosa. The patient remained asymptomatic at a follow-up examination. Duodenal stenosis should be considered in the complications of ascariasis, particularly in areas where this parasitic infestation is endemic.
Key Words: Duodenal stenosis, Ascaris lumbricoides
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