Biliary ascariasis

Case contributed by Dr Praveen Jha

Presentation

Recurrent and chronic chonlangitis features. Gall bladder is post-operative.

Patient Data

Age: 40 years
Gender: Male
Modality: MRI

Curvilinear and irregular serpiginous flow voids are seen in distal common bile duct, with obstructive biliary dilatation..

Case Discussion

While the common bile duct stones mostly appear as discrete and round signal voids, biliary ascariasis, as expected, are seen as curvilinear tubular (live worm) or amorphous (dead worm) stuctures. In this case, they appear fragmented and amorphous with some well outlined thin curvilinear projections, consistent with dead worms.

Biliary ascariasis is still prevalent in many of the rural areas of developing countries. This patient had a similar background.  Also, it is common practice to prescribe Albendazole (anti-helminthic) frequently as empirical measure. Probably, this patient also received Albendazole during prior treatments.

Other differential would be choledocholithiasis.

PlayAdd to Share

Case Information

rID: 25029
Case created: 29th Sep 2013
Last edited: 12th Mar 2017
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.