Ascariasis of the pancreatic duct.

Abstract

Ascariasis is a common helminthic disease worldwide, although Lithuania and other European countries are not considered endemic areas. The presence of the Ascaris worm in the biliary tree causes choledocholithiasis-like symptoms. We report a case of pancreatic duct ascariasis causing such symptoms. A 73-year-old Lithuanian woman underwent endoscopic retrograde cholangiopancreatography (ERCP) suspecting choledocholithiasis. Contrast injection into the common bile duct demonstrated a slightly dilated biliary tree without any filling defects, and the tail of an Ascaris worm protruding from the opening of the papilla Vater. The worm was captured by a snare but escaped deep into the duct. After a small wirsungotomy the worm was retrieved from the pancreatic duct. The patient received a 150 mg dose of levamisole orally repeated 7 days later and was discharged after complete resolution of symptoms. This first reported sporadic case of pancreatic duct ascariasis in Lithuania was successfully treated with ERCP and Levamisole.

• Authors: Michail Klimovskij, Audrius Dulskas, Zita Kraulyte, Saulius Mikalauskas
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2015 (Sep 15 2015) ISSN: 1757-790X [Electronic] England
• PMID: 26374772 (Publication Type: Case Reports, Journal Article)
• Copyright: 2015 BMJ Publishing Group Ltd.

Chemical References

• Antinematodal Agents
• Levamisole

Topics

• Abdominal Pain (etiology, parasitology)
• Aged
• Animals
• Antinematodal Agents (therapeutic use)
• Ascariasis (complications, diagnosis, drug therapy)
• Ascaris lumbricoides (isolation & purification)
• Cholangiopancreatography, Endoscopic Retrograde
• Choledocholithiasis (diagnosis)
• Diagnosis, Differential
• Female
• Humans
• Jaundice, Obstructive (etiology, parasitology)
• Levamisole (therapeutic use)
• Pancreatic Ducts (parasitology)
• Treatment Outcome