Traditional herbal medicine therapy of gallbladder ascariasis: a case report

Abstract

Background Ascariasis is one of the common intestinal infections in developing countries, including China. Migration of Ascaris lumbricoides into the gallbladder is rare, unlike ascariasis of the bile duct and when it does occur, treatment is generally by endoscopic or surgical extraction. Case presentation A 4-year-old Uyghur boy with a history of ascariasis developed intermittent upper abdominal pain for 7 days, was being treated by a local practitioner, and when the pain worsened with yellow sclera for 3 days, he was admitted to our hospital. On physical examination, found out the patient with yellowish skin tone, pale yellow fur on tongue, mild yellow staining of the sclera and tenderness in epigastrium. Laboratory data plus liver function test showed damage of liver function. Abdominal Ultrasonography (USG) and Magnetic resonance cholangiopancreatography (MRCP) showed a long, linear, echogenic structure in the gallbladder neck near to the common bile duct. Once the ascariasis diagnosis was established, he was given conservative treatment of magnesium sulfate with herbal medicine. In 4 days, the patient discharged Ascaris through the stool. Conclusions Conservative treatment of magnesium sulfate with Uyghur medicine treatment according to syndrome differentiation is proven to have curative effect.

An Overview of Ascariasis Involvement in Gallbladder Disease: A Systematic Review of Case Reports

“…The AW shows up in imaging studies as a curved/linear moving echogenic structure with an anechoic central line and characteristic movement of these long echogenic structures within the bile duct. The AW localized within the gallbladder can present as an echogenic-filing defect appearing as a bull's eye [1,5,[9][10][11][13][14][15]. Figure 4 shows the AW in the gallbladder presenting with a bull's eye appearance.…”

“…A. lumbricoides typically presents in the gall bladder as acute acalculous cholecystitis. A. lumbricoides is the most common helminth; patients can have repeat occurrences of ascariasis disease [ 1 , 15 ]. Some countries (endemic regions in the Middle East, Far East, India, Latin America, and Africa) are more prone due to low socioeconomic status and lack of awareness about appropriate sanitary practices [ 12 , 13 ].…”

“…A. lumbricoides infections are highly asymptomatic, and an adult AW can stay dormant in the lumen of the small intestine for a year or more. Small bowel obstruction is a common finding in infected human hosts [ 1 , 13 ]. Partial or complete intestinal obstruction is the primary clinical manifestation associated with pediatric hospitalization for ascariasis [ 18 ].…”

“…It is rare for the AW to invade the gall bladder because the biliary tract is fragile, narrow, and tortuous; only 2.1% of hepatobiliary ascariasis comes from the gallbladder [ 1 , 9 ]. The anatomical structure of the cystic duct makes it tedious for the AW to migrate to the gallbladder when there is a low count of worm infestation.…”

“…Over one billion people worldwide have an Ascaris worm (AW) infection known as ascariasis. Ascaris lumbricoides (A. lumbricoides ), the prominent human roundworm, is a parasitic nematode frequently found in endemic developing countries [ 1 , 2 ]. Ascariasis is prevalent in tropical areas with high-risk hygiene behaviors and inadequate sanitation [ 3 ].…”