Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
권호 표지

A Case of Biliary Ascariasis with Duodenal Stenosis

십이지장 협착을 동반한 총담관 회충미입증 1예

  • Park, Kang-Jin (Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Chung, Cho-Yun (Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Song, Young-A (Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Sang-Hun (Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Park, Chung-Su (Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Cho, Sung-Bum (Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Lee, Wan-Sik (Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Joo, Young-Eun (Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School)
  • 박강진 (전남대학교 의과대학 소화기내과학교실) ;
  • 정조윤 (전남대학교 의과대학 소화기내과학교실) ;
  • 송영아 (전남대학교 의과대학 소화기내과학교실) ;
  • 김상훈 (전남대학교 의과대학 소화기내과학교실) ;
  • 박정수 (전남대학교 의과대학 소화기내과학교실) ;
  • 조성범 (전남대학교 의과대학 소화기내과학교실) ;
  • 이완식 (전남대학교 의과대학 소화기내과학교실) ;
  • 주영은 (전남대학교 의과대학 소화기내과학교실)
  • Published : 2011.06.30
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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.

회충은 가장 흔한 장관 내 기생충 감염의 원인으로 대개는 별다른 증상을 일으키지 않으나 위장관의 여러 부위에 이소미입이 일어날 수 있고 이로 인해 장폐쇄, 췌담관질환, 맹장염, 복막염 등의 여러 가지 위장관질환을 유발할 수 있다. 국내의 경우 성공적인 기생충 관리로 회충 감염률이 낮은 상태이나, 최근 기생충감염의 증가 가능성이 제기되고 있으며 이와 관련된 증례도 드물게 보고되고 있다. 상부소장폐쇄의 경우 회충의 종괴형성에 의한 완전 또는 불완전 폐쇄에 대한 보고가 2예 있었으나, 회충증에 의한 십이지장 협착을 보고한 예는 없었다. 저자들은 지속적인 상복부 통증과 구토를 주소로 내원한 환자에서 총담관내 회충미입증과 동반된 십이지장 협착을 진단하고 치료한 1예를 경험하여 보고한다.

Keywords

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