Assuntos
Ducto Colédoco/parasitologia , Fasciola hepatica/isolamento & purificação , Fasciola hepatica/fisiologia , Fasciolíase/diagnóstico , Animais , Anti-Helmínticos/uso terapêutico , Pré-Escolar , Colecistectomia , Terapia Combinada , Fasciolíase/tratamento farmacológico , Fasciolíase/cirurgia , Humanos , Masculino , Resultado do Tratamento , Triclabendazol/uso terapêutico , UltrassonografiaAssuntos
Colangite/parasitologia , Dor Abdominal/parasitologia , Doença Aguda , Albendazol/uso terapêutico , Ampola Hepatopancreática/diagnóstico por imagem , Ampola Hepatopancreática/parasitologia , Animais , Anti-Helmínticos/uso terapêutico , Antibacterianos/uso terapêutico , Ascaris lumbricoides/isolamento & purificação , Colangiopancreatografia Retrógrada Endoscópica , Colangiopancreatografia por Ressonância Magnética , Colangite/diagnóstico por imagem , Colangite/tratamento farmacológico , Ducto Colédoco/diagnóstico por imagem , Ducto Colédoco/parasitologia , Feminino , Febre/parasitologia , Humanos , Icterícia/parasitologia , Pessoa de Meia-Idade , Havaiano Nativo ou Outro Ilhéu do PacíficoAssuntos
Ascaris lumbricoides/isolamento & purificação , Colangite/diagnóstico , Abscesso Hepático/diagnóstico , Hepatopatias Parasitárias/diagnóstico , Choque Séptico/diagnóstico , África , Albendazol/uso terapêutico , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Animais , Anti-Helmínticos/uso terapêutico , Colangiopancreatografia Retrógrada Endoscópica , Colangite/parasitologia , Colangite/cirurgia , Ducto Colédoco/diagnóstico por imagem , Ducto Colédoco/parasitologia , Ducto Colédoco/cirurgia , Descompressão Cirúrgica , Drenagem , Feminino , Humanos , Klebsiella pneumoniae/isolamento & purificação , Fígado/diagnóstico por imagem , Fígado/parasitologia , Fígado/cirurgia , Abscesso Hepático/parasitologia , Abscesso Hepático/terapia , Hepatopatias Parasitárias/parasitologia , Hepatopatias Parasitárias/terapia , Pessoa de Meia-Idade , Choque Séptico/microbiologia , Choque Séptico/terapia , Doença Relacionada a Viagens , Resultado do TratamentoRESUMO
We report the case of a 60-year-old Peruvian female who was admitted with abdominal pain and jaundice. Cholangioscopy revealed a leaf-like trematode, Fasciola hepatica. This trematode was extracted with a Dormia's basket via endoscopic retrograde cholangiopancreatography (ERCP).
Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Doenças do Ducto Colédoco/parasitologia , Doenças do Ducto Colédoco/cirurgia , Ducto Colédoco/parasitologia , Fasciola hepatica/isolamento & purificação , Fasciolíase/cirurgia , Animais , Feminino , Humanos , Pessoa de Meia-IdadeAssuntos
Ascaríase/parasitologia , Ducto Colédoco/parasitologia , Ductos Pancreáticos/parasitologia , Pancreatite/parasitologia , Dor Abdominal/parasitologia , Doença Aguda , Adolescente , Ascaríase/complicações , Ascaríase/diagnóstico , Ascaríase/cirurgia , Colangiopancreatografia Retrógrada Endoscópica , Ducto Colédoco/diagnóstico por imagem , Ducto Colédoco/cirurgia , Endossonografia , Feminino , Humanos , Ductos Pancreáticos/diagnóstico por imagem , Ductos Pancreáticos/cirurgia , Pancreatite/diagnóstico , Resultado do TratamentoAssuntos
Colangite/etiologia , Ducto Colédoco/parasitologia , Fasciolíase/complicações , Anti-Helmínticos/uso terapêutico , Benzimidazóis/uso terapêutico , Colangiopancreatografia Retrógrada Endoscópica , Colangite/parasitologia , Ducto Colédoco/patologia , Dilatação Patológica , Fasciolíase/diagnóstico , Fasciolíase/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , TriclabendazolRESUMO
Fascioliasis is an infectious disease caused by the hepatic trematodes Fasciola hepatica and Fasciola gigantica. Here, we report the case of Fasciola gigantica presenting with biliary obstruction and abdominal pain that was diagnosed and treated by endoscopic retrograde cholangiography (ERCP). A 46-year-old woman presented with right upper quadrant abdominal pain and jaundice. Physical examination revealed icterus and hepatomegaly. Laboratory findings revealed an increase in liver transaminases and bilirubin. Abdominal ultrasonography showed extrahepatic and intrahepatic bile duct dilatation. The patient underwent ERCP. One live Fasciola gigantica was removed from the common bile duct by ERCP. In conclusion, fascioliasis should be considered in the differential diagnosis of obstructive jaundice, especially in endemic regions, and it should be kept in mind that ERCP plays an important role in the diagnosis and treatment of these patients. To our knowledge, this is the second case report of Fasciola gigantica treated by ERCP in Turkey.
Assuntos
Colestase/diagnóstico , Fasciola/isolamento & purificação , Fasciolíase/diagnóstico , Dor Abdominal/parasitologia , Dor Abdominal/patologia , Animais , Colangiopancreatografia Retrógrada Endoscópica , Colestase/complicações , Colestase/parasitologia , Colestase/cirurgia , Ducto Colédoco/parasitologia , Ducto Colédoco/patologia , Diagnóstico Diferencial , Fasciolíase/complicações , Fasciolíase/parasitologia , Fasciolíase/cirurgia , Feminino , Hepatomegalia/parasitologia , Hepatomegalia/patologia , Humanos , Icterícia Obstrutiva/diagnóstico , Icterícia Obstrutiva/patologia , Fígado/parasitologia , Fígado/patologia , Pessoa de Meia-Idade , TurquiaRESUMO
Rupture of hydatid liver cyst into biliary tree is frequent complications that involve the common hepatic duct, lobar biliary branches, the small intrahepatic bile ducts,but rarely rupture into common bile duct. The rupture of hydatid cyst is serious life threating event. The authors are reporting a case of total rupture of hydatid cyst of liver into common bile duct. A 50-year-old male patient who presented with acute cholangitis was diagnosed as a case of totally rupture of hydatid cyst on Abdominal CT Scan. Rupture of hydatid cyst of liver into common bile duct and the gallbladder was confirmed on surgery. Treated by cholecystectomy and T-tube drainage of Common bile duct.
Assuntos
Ducto Colédoco/patologia , Ducto Colédoco/parasitologia , Equinococose Hepática/patologia , Ruptura Espontânea/patologia , Colecistectomia , Ducto Colédoco/cirurgia , Drenagem , Equinococose Hepática/complicações , Equinococose Hepática/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Ruptura Espontânea/parasitologia , Ruptura Espontânea/terapiaRESUMO
CONTEXT: Ascaris lumbricoides is one of the most common parasitic infestations of human gastrointestinal tract. This parasitic infestation might be asymptomatic and only few studies on extraintestinal ascariasis have been reported. Ascending cholangitis and acute pancreatitis as a result of the Ascaris lumbricoides migrating into the biliary system and pancreatic duct were very rare complications. Here, we presented a case report of biliary ascariasis induced acute pancreatitis with cholangitis without imaging supported in a patient coming from urban area. CASE REPORT: A 33-year-old woman lives in Bangkok, urban area of Thailand. She presented with severe epigastric pain for one day. Her diagnosis was Ascaris lumbricoides induced acute pancreatitis accompanied with ascending cholangitis. The investigation results showed no eosinophilia and no ascaris eggs in stool examination. The abdominal computed tomography showed slightly common bile duct dilatation. The parasite was found during an endoscopic retrograde cholangiopancreatography performed. The cholangiography revealed a roundworm in common bile duct. The parasite was successfully removed by using an extraction balloon catheter and a snare. Microbiological examination of the parasite revealed a 22 cm long adult form of Ascaris lumbricoides. CONCLUSION: Ascaris lumbricoides is the uncommon cause of biliary obstruction with complications. It is also a possible cause even in the patients who live in urban areas. Endoscopic removal is the treatment of choice in addition to antihelminthic medications.
Assuntos
Ascaríase/complicações , Colangite/etiologia , Ducto Colédoco/patologia , Pancreatite/etiologia , Doença Aguda , Adulto , Animais , Ascaríase/parasitologia , Ascaris lumbricoides/fisiologia , Colangiopancreatografia Retrógrada Endoscópica , Colangite/diagnóstico , Cidades , Ducto Colédoco/parasitologia , Feminino , Interações Hospedeiro-Parasita , Humanos , Pancreatite/diagnóstico , TailândiaRESUMO
Fasciola hepatica is an endemic zoonotic disease in Turkey and neighboring countries. The usual definitive host is the sheep; humans are accidental hosts in the life cycle of the Fasciola. There are two disease stages: the hepatic (acute) and biliary (chronic) stages. When the flukes enter the bile ducts, the symptoms of cholestasis and cholangitis may present, which can easily be misdiagnosed as obstructive jaundice of other causes. We present a case of fascioliasis, which was difficult to differentiate from cholangiocarcinoma. A 47-year-old woman from Eastern Turkey presented with fever, right upper quadrant abdominal pain, and jaundice. Total bilirubin was 4.2 mg/dl, aspartate aminotransferase 55 IU/L, alanine aminotransferase 65 IU/L, alkaline phosphatase 325 IU/L, and gamma-glutamyl transpeptidase 172 IU/L. All tumor markers including carcinoembryonic antigen and Ca19-9 were in normal values. After extended evaluation, an explorative laparotomy with cholecystectomy, choledochostomy and T-tube drainage was performed. Multiple flukes were removed from the choledochus. One of the parasites was sent to the parasitological clinic for identification. The result of an indirect hemagglutination test for F. hepatica was 1/320 (+). In conclusion, the chronic phase of this zoonotic infection can be easily misdiagnosed as any other cause of obstructive jaundice. Thus, F. hepatica should be considered in the differential diagnosis of common bile duct obstruction, especially in endemic areas.
Assuntos
Neoplasias dos Ductos Biliares/diagnóstico , Colangiocarcinoma/diagnóstico , Fasciola hepatica/isolamento & purificação , Fasciolíase/complicações , Icterícia Obstrutiva/etiologia , Animais , Ductos Biliares Intra-Hepáticos , Biópsia , Ducto Colédoco/parasitologia , Diagnóstico Diferencial , Fasciolíase/diagnóstico , Fasciolíase/parasitologia , Feminino , Humanos , Icterícia Obstrutiva/diagnóstico , Icterícia Obstrutiva/parasitologia , Imageamento por Ressonância Magnética , Pessoa de Meia-IdadeRESUMO
Liver hydatid cysts are known to rupture into the biliary tree, but acute pancreatitis is a rare complication of intra-biliary rupture. Intra-biliary rupture was first reported in 1928 by Dew. Intra-biliary rupture is a serious complication of hepatic hydatid cysts. The incidence varies from 1% to 25% in adult patients. In our case, we aimed to show the migration of the material of a hepatic hydatid cyst to the common bile duct and the impaction of hydatid membrane in the papillary orifice, which may cause acute pancreatitis. Parasitic infections should be considered as a differential diagnosis in patients with acute biliary pancreatitis.
Assuntos
Doenças Biliares/complicações , Equinococose Hepática/complicações , Pancreatite/parasitologia , Doenças Biliares/diagnóstico , Ducto Colédoco/parasitologia , Diagnóstico Diferencial , Equinococose Hepática/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite/diagnóstico , Pancreatite/etiologia , Ruptura Espontânea/complicações , Ruptura Espontânea/diagnósticoRESUMO
BACKGROUND/AIMS: Gallbladder ascariasis is rarely encountered. The causative agent is Ascaris lumbricoides. Presence of ascaris inside the gallbladder can incite acalculous cholecystitis. We aimed in this report to study gallbladder ascariasis. METHODS: This is a case study of 28 patients with a diagnosis of gallbladder ascariasis from 2005 to 2010 who were seen in the Department of General Surgery, SMHS Hospital. RESULTS: Three patients with gallbladder ascariasis had associated worms in the common bile duct. On abdominal sonography, all patients showed worms as linear echogenic shadows or the worms showed 'belly dance' of worms when actively moving. Acute acalculous cholecystitis was present in 21 patients, and 7 had biliary colic. Dead worms in the gallbladder were seen in 4 patients, of which, one was fragmented and another had calcified form of parasite. Twenty-two patients had spontaneous exit of worms from the gallbladder with a time interval ranging from 1 hour to 144 hours from the time of a diagnosis. Six patients had cholecystectomy. Two patients were subjected to emergency cholecystectomy due to multiple impacted worms not exiting from the gallbladder after conservative treatment. CONCLUSIONS: Based on our experience, ultrasound diagnosis is advocated as a highly sensitive and noninvasive technique for suspected gallbladder ascariasis and it can be repeated frequently to monitor movement of worms in the gallbladder and common bile ducts.
Assuntos
Ascaríase/complicações , Ascaris lumbricoides , Doenças da Vesícula Biliar/parasitologia , Adolescente , Adulto , Idoso , Animais , Ascaríase/cirurgia , Ascaríase/terapia , Criança , Pré-Escolar , Ducto Colédoco/parasitologia , Feminino , Vesícula Biliar/parasitologia , Doenças da Vesícula Biliar/cirurgia , Doenças da Vesícula Biliar/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Carga Parasitária , Adulto JovemAssuntos
Ascaríase/diagnóstico por imagem , Ascaris/isolamento & purificação , Doenças dos Ductos Biliares/diagnóstico por imagem , Ducto Colédoco/diagnóstico por imagem , Endossonografia , Adulto , Animais , Ascaríase/parasitologia , Ascaríase/cirurgia , Doenças dos Ductos Biliares/parasitologia , Doenças dos Ductos Biliares/cirurgia , Colangiopancreatografia Retrógrada Endoscópica , Ducto Colédoco/parasitologia , Ducto Colédoco/cirurgia , Feminino , Humanos , Valor Preditivo dos Testes , Resultado do TratamentoAssuntos
Ducto Colédoco/parasitologia , Fasciola hepatica/isolamento & purificação , Fasciolíase/diagnóstico , Adulto , Animais , Colangiopancreatografia Retrógrada Endoscópica , Ducto Colédoco/diagnóstico por imagem , Ducto Colédoco/cirurgia , Fasciolíase/parasitologia , Fasciolíase/cirurgia , Feminino , Humanos , Esfinterotomia Endoscópica , UltrassonografiaRESUMO
Due to the anatomical characteristics of the biliary tract, Ascaris lumbricoides rarely settles in the gallbladder, which makes biliary ascariasis a rare clinical condition. Ultrasonography plays a significant and practical role in the diagnosis and follow-up of suspected cases of biliary ascariasis. The 15-year-old case presented herein had been complaining of abdominal pain and dyspepsia for three months, and the clinical and laboratory findings for the patient indicated acute abdomen. Abdominal ultrasonography showed worms consistent with Ascaris inside a normal-sized gallbladder, dilated choledochus and the pancreatic duct. We started antiparasitic treatment in the patient, with cholangitis and pancreatitis diagnoses. Post-treatment follow-up ultrasonography showed a normal gallbladder, choledochus and pancreatic duct.
Assuntos
Ascaríase/diagnóstico por imagem , Ascaris lumbricoides/isolamento & purificação , Ducto Colédoco/parasitologia , Doenças da Vesícula Biliar/parasitologia , Ductos Pancreáticos/parasitologia , Adolescente , Animais , Ducto Colédoco/diagnóstico por imagem , Feminino , Vesícula Biliar/diagnóstico por imagem , Vesícula Biliar/parasitologia , Doenças da Vesícula Biliar/diagnóstico por imagem , Humanos , Ductos Pancreáticos/diagnóstico por imagem , Doenças Raras/patologia , UltrassonografiaRESUMO
A 56 year old woman was admitted to the clinic with severe colicky right upper abdominal pain. There was a three-week history of jaundice. Pathological biochemical laboratory results of her serum were as follows: direct bilirubin 4.53 mg/dl, total bilirubin 3.08 mg/dl, AST 45 U/L, ALT 72 U/L. Surgical treatment, cholecystectomy + choledochtomy + T-tube drainage, was performed. Exploration of the choledochus revealed two Fasciola hepatica. The patient was also given antihelmintic treatment. We present a case of fascioliasis-induced acute cholangitis that was diagnosed and treated via surgery. A review of the literature on extraction of living parasites is also included.