Presentation
Abdominal pain, jaundice and ill-looking patient.
Patient Data
Scan of the liver with high frequency linear probe shows multiple linear echogenic structures within dilated intrahepatic ducts.
some small focal cystic lesions with internal fluid-debris level are also seen.
CT images show dilatation of intrahepatic ducts with multiple small hypo-attenuating lesions in hepatic parenchyma.
Prominent common bile duct and marked dilatation of pancreatic duct was also noted, which can also give the possibility of ascaris worms in these ducts.
Mild ascites was present.
Case Discussion
Combination of the ultrasonographic and CT findings are more likely of biliary ascariasis complicated by abscess formation.
The patient was lost to further follow-up.