[Gallbladder ascariasis with acute hepatitis. Conservative treatment].
We report two cases of gallbladder ascaridiasis associated with acute hepatitis, its clinical evolution with conservative treatment, making diagnosis by both laboratory and ultrasono-graphic 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.
Montiel-Jarquín
Alvaro
A
Departamento de Cirugía General, Hospital General Regional No. 36. "San Alejandro" Instituto Mexicano del Seguro Social, IMSS, Puebla, México. dralmoja@hotmail.com
Carrillo-Ríos
Cristina
C
Flores-Flores
Jesús
J
D000208:Acute Disease; D000328:Adult; D000818:Animals; D001196:Ascariasis / Q000175:diagnosis / Q000469:parasitology* / Q000628:therapy; D017164:Ascaris lumbricoides / Q000302:isolation & purification*; D002648:Child; D002764:Cholecystitis / Q000175:diagnosis / Q000469:parasitology* / Q000628:therapy; D005260:Female; D006505:Hepatitis / Q000469:parasitology* / Q000628:therapy; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome