2003, Number 4
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ABSTRACTWe report two cases of gallbladder ascaridiasis associated with acute hepatitis, its clinical evolution with conservative treatment, making diagnosis by both laboratory and ultrasonographic studies. Case 1: was a male in his early forties who experienced symptoms of acute hepatitis and cholecystitis within a time lapse of 72 h of evolution. When laboratory tests and ultrasound (US) were done, an ascaris inside gallbladder was corroborated. There were also alterations compatible with acute non-viral hepatitis. Conservative treatment was done with observations within an 8-day period that hepatic examinations were normal as well as absence of helminthus inside gallbladder. Case 2: A 10-year-old female, who expelled worms 8 months previously had 11 days evidence of acute cholecystitis and hepatitis. An ultrasound of liver and biliary tract was done, with evidence of Ascaris lumbricoides inside gallbladder, with alterations in hepatic tests. This was medically treated, achieving expulsion of the Ascaris lumbricoides from inside the gallbladder and normalization of liver function tests. Gallbladder ascaridiasis management may be conservative. Patient general condition must be evaluated, as well or medical evolution and associated pathologies that may interfere in certain ways in surgery. Follow-up of these patients must be strict, with medical evaluation and laboratory controls.
Cork GC, editor. Mansons’s tropical diseases. 20th ed. WB Saunders; 1996.
Tay ZJ, Velazco CO, Lara AR, Gutiérrez QM. Parasitología médica. 5th ed. México: Méndez Editores; 1990. pp. 301-313.
Chester BP, Clifton JR, Wayne CE. Parasitología clínica. 2nd ed. Barcelona Spain: Salvat Editores; 1990. pp. 327-361.
Benítez García F, Pacahuala del Carmen M. Ascariasis en vías biliares. Presentación de dos casos. Rev Med IMSS 1999;37(1):19-23.
Javid G, Wani N, Gulzar G, Javid O, Khan B, Shah A. Gallbladder ascariasis: presentation and management. 1999;86(12):1526-1527.
Wani NA, Chrungoo RK. Biliary ascariasis: surgical aspects. World J Surg 1992;16:976-979.
Tovia AM, Cisneros ST. Parasitosis de las vías biliares. Rev Gastroenterol Mex 1974;39:391-397.
Gómez AA, Orozco SO, Amador RV, Villeda AA, Campa GR. Ascariasis hepática. Reporte de un caso. Rev Med IMSS 1992;30:31-34.
Khuroo MS, Zargar SA, Mahahan R. Hepatobiliary and pancreatic ascariasis in India. Lancet 1990:335:1503-1506.
Beckingham IJ, Cullis SN, Krige JEJ, Bornman PC, Terblanche J. Management of hepatobiliary ascaris infestation after failed medical treatment. Br J Surg 1998;85(1S):77-78.
Beckingham IJ, Cullis SN, Krige JEJ, Bornman PC, Terblanche J. Management of hepatobiliary and pancreatic ascaris infestation in adults after failed medical treatment. Br J Surg 1998;85(7):907-910.
Santillán DP, Juárez CF, Guraieb BE, Gallo RS, De la Rosa LC. Parasitosis de vías biliares: Ascaris lumbricoides. Rev Invest Clin 1986;38:297-302.
Quintos AC, Romero JG, Athié AA, Ibáñez FJ, Santamaría LE, Velázquez MR. Ascariasis biliar. Experiencia en el Hospital General “Dr. Manuel Gea González”. Rev Gastroenterol Mex 1990;55:61-65.
Fayez S, Samir H, Zada MM, Graham DY, Anand BS. Pancreatic-biliary ascariasis: experience of 300 cases. Am J Gastroenterol 1997;92(12):2264-2267.
Gerdes MM, Boyden EA. The rate of emptying of the human gallbladder in pregnancy. Surg Gynecol Obstet 1938;66:145-146.
Asrat T, Rogers N. Acute pancreatitis caused by biliary ascaris in pregnancy. J Perinatol 1995;15(4):330-332.
Cheroot MS, Zargar SA, Yattoo GN, Dar MY, Javid G, Khan BA, et al. Sonographic findings gallbladder ascariasis. J Clin Ultrasound 1992;20:587-591.
Rollo IM. Drugs used in the chemotherapy of helminthiasis. In: Gilman AG, Goodman LS, Gilman A, editors. Goodman and Gilman’s. The pharmacological basis of therapeutics. 6th ed. New York: MacMillan; 1980. pp.1013-1037.
Witassek F, Allan RJ, Watson TR, Woodtli W, Ammann R, Bircher J. Preliminary observations on the biliary elimination of mebendazole and its metabolites in patients with echinococcosis. Eur J Clin Pharmacol 1983;25:81-84.
Van den Bogaerde JB, Jordaan M. Intraductal administration of albendazole for biliary ascariasis. Am J Gastroenterol 1997;92(9): 1531-1533.
Tankhiwale SR, Kukade AL, Sarmah HC, et al. Single dose therapy of ascariasis: a randomized comparison of mebendazole and pyrantel. J Commun Dis 1989;21:71-74.
Reynolds JEF, Martindale. The extra pharmacopoea. 21st ed. London: Royal Pharmaceutical Society; 1996. pp.16-25.
Lloyd DA. Massive hepatobiliary ascariasis in childhood. Br J Surg 1981;68:468-473.
James T. Ascaris abscess of the liver. Med Proc 1970;16:127-131.
Park CH, Nold RJ, Kuehn HW, et al. Common bile duct obstruction by ascaris with hepatic abscesses. V Med Mon 1968;95:725-727.
Wang H-C, T’ang CH, Liu HH, et al. Biliary ascariasis. An analysis of 141 cases. Ch Med J 1956;74:445-455.
Manialawi MS, Khattar NY, Helmy MM, Burcharth F. Endoscopic diagnosis and extraction of biliary ascaris. Endoscopy 1986;18: 204-205.
Kamiya T, Justiano M, Durán A, Uechi C. Biliopancreatic ascariasis: endoscopic approach. J Gastroenterol 2002;37(Suppl 13):97-99.
Chugh TD, Khurana S, Kaur H, et al. Hepatic ascariasis. Indian J Pathol Bacteriol 1970;13:38-40.