Ascaris‐induced Liver Abscess

Abstract

The prevalence, symptomatology, and outcome of Ascaris-induced liver abscess was studied prospectively in Kashmir, India, which is an endemic area of ascariasis, from December 1987 to December 1997. Of 510 patients with liver abscess admitted during this period, 74 had biliary ascariasis as the cause (14.51%). Of these 74 patients, 11 had intact ascaridae (live or dead) within the abscess. Six patients had a single abscess, and five had multiple abscesses. Seven patients had associated worms in the bile ducts. Ultrasonography was the main diagnostic procedure used. Ten patients were diagnosed based on clinical and ultrasound findings, and one was diagnosed during laparotomy. Most of the patients were young (age range 3-40 years) with a mean age of 17.20 years. Seven were females, and four were males. Ten patients underwent surgery; nine recovered completely, and one died postoperatively due to septicemia. Another patient died as well: a young child who presented late, was in refractory septic shock following suppurative cholangitis and liver abscess, and could not be taken for surgery. The mortality thus was 9.9%. Liver abscess following invasion of intrahepatic biliary radicles by ascaridae through the ampulla is an unusual complication of an otherwise common disease in Kashmir Valley, affecting children and young adults. The outcome depends on early diagnosis and surgical drainage of the abscess with extraction of worms from the ducts.

Liver abscess in children: an overview

“…Biliary ascariasis associated with cholangitis and LA is common in the areas where ascariasis is endemic, like the Kashmir valley in India. [14] Protein calorie malnutrition also predisposes to LA in children probably due to immunosupressed state. Of 84 childhood LA studied over a 10-year period by Hendricks et al, [1] 56% of the patients had protein calorie malnutrition.…”

Ascaris and ascariasis

“…An inflammatory reaction in the liver has been observed in A. lumbricoides- [64] and A. suum- [65] infected humans, pigs [66][67][68][69] and model organisms such as calves [70], M A N U S C R I P T…”

Ascariasis as a cause of hepatic abscess: A report of 3 cases

“…We reviewed the literature and found that ascariasis is very common cause of hepatic abscess in the neighboring state of Jammu and Kashmir, where 74 cases of biliary ascariasis as a cause of hepatic abscess have been reported. [1] Of these 11 had intact ascaridae (live or dead) within the abscess. Six patients had a single abscess, and five had multiple abscesses.…”