title: [Biliary ascariasis after cholecystectomy and papillotomy in a non-endemic area].
abstract: METHODS
  A 61-year-old woman was admitted to hospital with nausea and vomiting. Four years earlier she had undergone cholecystectomy and papillotomy.
  
  
  METHODS
  Laboratory examination showed a slight increase of aspartate and alanine aminotransferase, glutamyl transpeptidase, and moderate eosinophilia. Ultrasound revealed an elongated echogenic structure within the common bile duct. At endoscopic cholangiopancreaticography (ERCP) a 23 cm-long Ascaris lumbricoides was found.
  
  
  METHODS
  The worm was removed endoscopically with forceps. Antihelmintic therapy with mebendazole was given. After that the patient was well and laboratory findings were normal.
  
  
  CONCLUSIONS
  Biliary ascariasis should also be considered in a non-endemic area. Previous cholecystectomy and papillotomy are predisposing factors. In our case ERCP was the diagnostic and therapeutic method of choice.
authors.affiliation: Medizinische Klinik, Klinikum Minden, Minden. s.koeppen@gmx.de
authors.forename: S
authors.initials: S
authors.lastname: Köppen
authors.forename: B
authors.initials: B
authors.lastname: Wejda
authors.forename: A
authors.initials: A
authors.lastname: Dormann
mesh_terms: D000818:Animals; D000969:Antinematodal Agents / Q000627:therapeutic use; D017164:Ascaris lumbricoides / Q000302:isolation & purification*; D001649:Bile Duct Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy / Q000009:adverse effects*; D003135:Common Bile Duct / Q000000981:diagnostic imaging / Q000469:parasitology*; D005260:Female; D006801:Humans; D008463:Mebendazole / Q000627:therapeutic use; D008875:Middle Aged; D008924:Mite Infestations / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects*; D014463:Ultrasonography
chemical_list: D000969:Antinematodal Agents; D008463:Mebendazole
vernacular_title: Biliäre Askariasis nach Cholezystektomie und Papillotomie in einem Nicht-Endemiegebiet.