Biliary ascariasis ‐ a worm in the duct

Abstract

OBJECTIVE: Migration of Ascaris lumbricoides into the biliary tree may cause biliary obstruction, cholangitis or pancreatitis. Although common in endemic areas, none of these complications have previously been reported in Australia. We report here a case of obstruction of the common bile duct by an ascarid. CLINICAL FEATURES: A 62-year-old female Vietnamese migrant presented with cholangitis and underwent a cholecystectomy. Subsequently, ultrasound and cholangiography revealed an ascarid in the common bile duct. INTERVENTION AND OUTCOME: This worm was endoscopically removed and the patient's symptoms rapidly resolved. CONCLUSION: As a result of increased migration to Australia, such cases will be recognised more frequently in the future. Patients at risk should be carefully imaged prior to definitive therapy.