Common bile duct worm
Right hypochondrial dull pain
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Abdominal scan in left lateral position revealed double linear echogenic wall tubular structure with no posterior shadowing in the proximal common bile duct, common hepatic duct and right hepatic duct. Common bile duct measures 7 mm in diameter. No intrahepatic bile ducts dilatation.
Parasitic infestation is common in this part of the world (India and Pakistan). The most common of them is the roundworm infestation. The commonest species is Ascaris lumbricoides. It commonly resides in the intestine, but rarely moves to the hepatobiliary system. On ultrasound, it appears as a double linear echogenic wall structure. In this patient, the classic picture can be seen.
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