Korean J Gastrointest Endosc.  2005 Nov;31(5):348-352.

A Case of Acute Pancreatitis Caused by Ascaris Invasion of the Common Bile Duct

• Byun JW
• Kim JW
• Choi H
• Kim HJ
• Kim KH
• Jee MG
• Park YS
• Baik SK
• Kim HS
• Kwon SO
• Kim SH

Abstract

Ascaris lumbricoides is the most common intestinal parasite in less-developed countries as well as in areas with poor sanitation. Highly motile mature worms may enter the ampulla of Vater and migrate to the bile or pancreatic ducts causing cholangitis, biliary stones, cholecystitis, pancreatitis and a liver abscess. The incidence of pancreatitis due to biliary ascariasis is relatively common in endemic areas, but only a few cases have been reported in Korea since 1990. A 68-year-old woman was admitted with a sudden onset of epigastric pain. She was diagnosed with acute pancreatits due to ascaris based on computed tomography, the ampulla-impacted state of the worm and an elevated serum amylase level. The patient recovered without complications after the ascaris had been extracted using grasp forceps during endoscopy. The patient also received antihelminthic therapy. We report this case with a review of the relevant literatures.

Keyword

Biliary ascariasis; Acute pancreatitis; Ampulla of Vater

MeSH Terms

Aged
Ampulla of Vater
Amylases
Ascariasis
Ascaris lumbricoides
Ascaris*
Bile
Cholangitis
Cholecystitis
Common Bile Duct*
Developing Countries
Endoscopy
Female
Hand Strength
Humans
Incidence
Korea
Liver Abscess
Pancreatic Ducts
Pancreatitis*
Parasites
Sanitation
Surgical Instruments
Amylases