Clinical and radiological observation in biliary ascariasis

Lee, P J; Kim, D H

Abstract

The author studied total 69 cases of biliary ascariasis, who had been admitted B.B.U. Hospital. St. Benedict,Busan Gosphel, and Baptist Hospital from January 1973 to January 1977, The results were summarized as follows; 1.The sex distribution of total cases was 57 cases (82.7%) in female and 12 cases (17.4%) in male, ie., the sexratio 1:4.7 (M:F) The predominant age incidence was 3rd and 4th decades as 37 cases (53.7%) 2. Important clinicalsymptoms and signs were severe epigastric pain which tend to other parts of the body, nausea, vomiting, RUQepigastric tenderness, and jaundice, but symptoms and signs were not differentiated that occurs in cholelithiasisand cholecystitis. 3. The liver function tests appeared to be slightly abnormal, due to the obstruction of thebiliary tracts, such as increased total serum bilirubin and elevated Alkaline phosphatase. 4. Stool examinationwas done in all of the cases by direct smear method. Ascites ova was positive in 54 cases (74%) 5. Preoperativelinical diagnosis of 69 cases was suspected as 26 cases (38) of choledochoascariasis, 11 cases were confirmed byI.V.C 6. I.V. cholangiograms showed cord-like filling defect within the common bile duct in 11 cases (44%) out of25 patients performed, and additional findings were dilated common bile duct over 11mm and loss of normal taperingof distal portion of CBD. 7. Postoperative findings revealed as 23 cases (33%) of choledochoascariasis withoutother disease, 23 cases (33%) combined with cholelithiasis, 18 cases (26%) with cholecystitis and cholangitis, and4 cases (5.8%) with empyema of gall-bladder.