Successful elimination of Ascaris lumbricoides from the gallbladder by conservative medical therapy.
Migration of Ascaris lumbricoides into the gallbladder is rare, unlike ascariasis of the bile duct, and, when it does occur, treatment is generally by endoscopic or surgical extraction. We describe a case of the successful treatment of gallbladder ascariasis with conservative therapy. A 44-year-old Korean man was admitted because of nausea and right upper quadrant pain that did not respond to medical control and had worsened 1 day before admission. Abdominal ultrasonography showed a long, linear, moving echogenic structure in the distended lumen of the gallbladder, but no abnormal dilation of the bile duct. Computerized tomography showed a linear soft-tissue density in the dependent portion of the gallbladder. The patient presented with eosinophilia, and abnormal liver function results, but no fever or hepatomegaly. Based on these findings, and presuming a diagnosis of gallbladder ascariasis, we administered antiparasitic medication (albendazole 400 mg/day for 1 day). Seven days later, we obtained one adult female A. lumbricoides from the feces. The symptoms were fully resolved, and no moving structure could be visualized in the gallbladder by ultrasonography. We recommend that initial therapy for gallbladder ascariasis should involve conservative treatment, unless an associated disease is present or a complication arises.
Cha
Dong Youb
DY
Department of Internal Medicine, Sun General Hospital, 10-7 Mok-dong, Jung-gu, Daejeon 301-070, Korea.
Song
In Kwan
IK
Choi
Hwan Won
HW
Chung
Eun A
EA
Shin
Bong Seok
BS
Song
Young Wook
YW
Lee
Sang Mi
SM
Kim
Hong Min
HM
Kim
Young Kwan
YK
Lee
Young-Ha
YH
Lee
Gye Sung
GS
D000328:Adult; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D001196:Ascariasis / Q000188:drug therapy*; D017164:Ascaris lumbricoides / Q000187:drug effects*; D005260:Female; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008297:Male; D011859:Radiography; D014463:Ultrasonography
D000871:Anthelmintics; D015766:Albendazole