Biliary ascariasis: ultrasonography, endoscopic retrograde cholangiopancreatography, and biliary drainage.
Roundworms migrating into the biliary tract are a relatively common cause of biliary symptoms in areas where the parasite is endemic. Visualization of worms by conventional radiologic methods is often unsatisfactory, whereas ultrasonography offers a rapid, safe, and noninvasive approach to the diagnosis. Using real-time ultrasonographic scanning we demonstrated for the first time the characteristic morphology of the worms in a patient with biliary ascariasis. In addition, the motility of the worms in the biliary tract could be confirmed. Ultrasonography is also a convenient method for the follow-up of patients. Endoscopic biliary drainage and instillation of piperazine citrate through a nasobiliary drain is a logical therapy and was used successfully in this patient.
D000328:Adult; D001196:Ascariasis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D001660:Biliary Tract Diseases / Q000469:parasitology*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004322:Drainage; D006801:Humans; D008297:Male; D010879:Piperazines; D014463:Ultrasonography
D010879:Piperazines; C006589:piperazine citrate