Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
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Biliary ascariasis misidentified as a biliary stent in a patient undergoing liver resection

  • Hochang Chae (Department of Surgery, College of Medicine, Chung-Ang University) ;
  • Suk Won Suh (Department of Surgery, College of Medicine, Chung-Ang University) ;
  • Yoo Shin Choi (Department of Surgery, College of Medicine, Chung-Ang University) ;
  • Hee Ju Sohn (Department of Surgery, College of Medicine, Chung-Ang University) ;
  • Seung Eun Lee (Department of Surgery, College of Medicine, Chung-Ang University) ;
  • Jae Hyuk Do (Department of Internal Medicine, College of Medicine, Chung-Ang University) ;
  • Hyun Jeong Park (Department of Radiology, College of Medicine, Chung-Ang University)
  • Received : 2023.01.30
  • Accepted : 2023.05.03
  • Published : 2023.05.31
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Abstract

Ascaris lumbricoides causes one of the most common soil-transmitted helminthiases globally. The worms mostly infect the human small intestine and elicit negligible or nonspecific symptoms, but there are reports of extraintestinal ectopic ascariasis. We describe a rare case of biliary ascariasis mistaken for biliary stent in a 72-year-old female patient with a history of liver resection. She visited our outpatient clinic complaining of right upper quadrant pain and fever for the past week. She had previously undergone left lateral sectionectomy for recurrent biliary and intrahepatic duct stones 2 years ago. Besides mildly elevated gamma-glutamyl transferase levels, her liver function tests were normal. Magnetic resonance cholangiopancreatography revealed a linear filling defect closely resembling an internal stent from the common bile duct to the right intrahepatic bile duct. A live female A. lumbricoides adult worm was removed by endoscopic retrograde cholangiopancreatography (ERCP). Despite a significant decrease of the ascariasis prevalence in Korea, cases of biliary ascariasis are still occasionally reported. In this study, a additional case of biliary ascariasis, which was radiologically misdiagnosed as the biliary stent, was described in a hepatic resection patient by the worm recovery with ERCP in Korea.

Keywords

Acknowledgement

This study was performed in accordance with the Declaration of Helsinki and an informed consent for publication was obtained from the patient.

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