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Korean J Parasitol > Volume 31(1):1993 > Article

Brief Communication
Korean J Parasitol. 1993 Mar;31(1):71-74. English.
Published online Mar 20, 1994.  http://dx.doi.org/10.3347/kjp.1993.31.1.71
Copyright © 1993 by The Korean Society for Parasitology
A case of biliary ascariasis accompanied by cholelithiasis
Min-Ho Choi,1In Ae Park,2Inn Kyu Hong,3Jong-Yil Chai,*1 and Soon-Hyung Lee1
1Department of Parasitology and Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul 110-799, Korea.
2Department of Pathology and Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul 110-799, Korea.
3Division of General surgery, Seoul City Boramae Hospital, Seoul 156-012, Korea.
Received December 22, 1992; Accepted January 14, 1993.

Abstract

A 43-year-old Korean woman with biliary ascariasis accompanied by cholelithiasis is reported. Her chief complaints were abdominal pain, nausea, and vomiting. She had the past history of several attacks of abdominal pain in her childhood. Biliary stones were recovered from the left hepatic duct after cholecystectomy, which contained degenerated cuticle or body wall, and numerous eggs of Ascaris lumbricoides. It is strongly suggested that the biliary stones were formed from the dead Ascaris worm(s). This is a rare case of biliary ascariasis during the recent 5 years in Korea.

Figures


Figs. 1-2
Fig. 1. Preoperative cholangiogram showing obstruction of the left hepatic (arrow) and the patent right duct. Fig. 2. T-tube cholangiogram after removal of sludge from the left hepatic duct. Obstruction of the left duct was somewhat relieved to show tubular dilatation, however, complete patency of the duct is not recognizable.


Figs. 3-4
Fig. 3. Microscopic view of the sludge showing degenerated cuticle (C), inflammatory cells chiefly composed of eosinophils and neutrophils. Fig. 4. Another area showing sections of parasite eggs with an embryonic cell, the albumin layer and the chitin layer, which are characteristic of fertilized A. lumbricoides ova.

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