title: Ascaris lumbricoides-induced acute pancreatitis: diagnosis during EUS for a suspected small pancreatic tumor.
abstract: BACKGROUND
  Ascaris lumbricoides is the second most common intestinal parasite world-wide and, although the infection can be asymptomatic, in some cases it can present with complications, such as acute pancreatitis.
  
  
  METHODS
  We describe the case of a 37-year-old man, with a history of travelling in Eastern countries who presented with Ascaris lumbricoides-induced acute pancreatitis mimicking a small pancreatic cancer, diagnosed during an upper EUS. The endoscopy revealeda roundworm floating in the duodenum; its endoultrasonographic appearance showed a diffuse inhomogeneous pattern, with hypoechoic echotexture, such as in acute pancreatitis. Microbiological examination of the worm revealed a 20 cm long Ascaris lumbricoides.
  
  
  CONCLUSIONS
  In non endemic countries, acute pancreatitis induced by Ascaris lumbricoides is an unusual diagnosis, and should be suspected especially in patients with history of traveling in endemic areas.
authors.affiliation: Gastroenterology and Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy. mangiavillano.benedetto@hsr.it
authors.forename: Benedetto
authors.initials: B
authors.lastname: Mangiavillano
authors.forename: Silvia
authors.initials: S
authors.lastname: Carrara
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Petrone
authors.forename: Paolo Giorgio
authors.initials: PG
authors.lastname: Arcidiacono
authors.forename: Pier Alberto
authors.initials: PA
authors.lastname: Testoni
mesh_terms: D000328:Adult; D000818:Animals; D001196:Ascariasis / Q000150:complications* / Q000000981:diagnostic imaging; D017164:Ascaris lumbricoides / Q000302:isolation & purification / Q000502:physiology*; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D019160:Endosonography; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000000981:diagnostic imaging; D008297:Male; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D010195:Pancreatitis / Q000000981:diagnostic imaging* / Q000209:etiology*; D047368:Tumor Burden; D041742:Upper Gastrointestinal Tract / Q000000981:diagnostic imaging