Biliary Ascariasis Diagnosed and Extracted by ERCP in the United States

An Uncommon Cause of Cholangitis and Cholecystitis

“…It is acquired through the ingestion of matured ova in contaminated water, raw vegetables, and food [1][2][3].…”

“…There, after moulting, they gain access to the alveolar space. Some will ascend the respiratory tree before being swallowed and reaching again the duodenum, where the final moulting to the adult state occurs [1,2]. Mature larvae inhabit the jejunum with a life span of 6-18 months, reaching up to 20-40 cm of length.…”

“…Females can release ∼200,000 eggs/day, excreted through the faeces. After 10-15 days in the soil, an intermediate maturation step occurs before these eggs become infectious [1,2].…”

“…Although the infestation is usually asymptomatic, some carriers develop clinical disease according to the organs strolled by the parasite throughout its life cycle: pneumo- nia, gastrointestinal occlusive symptoms, peritonitis, as well as pancreatic and hepatobiliary manifestations [1,2]. The latter arise when worms enter the ampulla of Vater and have a wide range: cholangitis, cholecystitis, hepatic abscesses, strictures, and biliary sludge and stones [1][2][3][4].…”

“…The latter arise when worms enter the ampulla of Vater and have a wide range: cholangitis, cholecystitis, hepatic abscesses, strictures, and biliary sludge and stones [1][2][3][4].…”