Title: Interesting Cause of Obstructive Jaundice Diagnosed by Endoscopic Ultrasound
Authors: Dhaval Choksi, Ruchir Patel, Prateik Poddar, Kaivan Shah, Meghraj Ingle, Prabha Sawant
DOI: http://dx.doi.org/10.18535/jmscr/v4i6.29
Hepatobiliaryascariasis is a common problem in tropical countries including India. It can present with intermittent symptoms and fluctuating imaging results and blood parameters as the worm migrates within the gastrointestinal tract. Patient can present with biliary colic, obstructive jaundice, ascending cholangitis, acalculouscholecystitis or acute pancreatitis. We present a case of obstructive jaundice in a 37 years old female, post cholecystectomy status. Patients abdominal ultrasound was apparently normal 1 week before jaundice, which was done for abdominal pain. Biliary ascariasis was diagnosed using endoscopic ultrasound (EUS). A live adult ascaris was removed from common bile duct (CBD) by endoscopic retrograde cholangiopancreatography (ERCP). KEYWORDS: Ascarislumbricoides, common bile duct, Endoscopic ultrasound, Endoscopic retrograde, cholangiopancreatography hepatobiliary, obstructive jaundice. 1. David EE. Sleisenger and Fordtran’s Gastrointestinal and Liver disease, 10th edition, Elsevier 2014. 2. Gupta R, et al. Biliary ascariasis complicating endoscopic sphincterotomy for choledocholithiasis in India. J Gastroenterol Hepatol. 1998;13:1072–1073 3. Mijandrušič-Sinčič, B., et al. Acute pancreatitis caused by Ascarislumbricoides: a case report. Gastrointest Endosc. 2008; 67: 541–542 4. Sharma, M. and Garg, S. Endoscopic ultrasound for ascaris in common bile duct. Endoscopy. 2009;41: E209–E210 5. Sandouk, F. et al. Pancreatic-biliary ascariasis: experience of 300 cases. Am J Gastroenterol. 1997; 2: 2264–2267Abstract
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