Ascaris-Induced Biliary Colic: a Case Report and Review Literatures

Abstract

Abstract: Biliary colic is a common symptom in general practice, mainly due to alcohol and biliary stone. On the other hand, its unusual cause is Ascaris lumbricoides especially in the developing countries. This worm can produce many symptoms in the gastrointestinal tract particularly hepatobiliary system. This is a case report of ascaris-induced biliary colic presenting with classical symptoms, signs and laboratory findings which were compatible with biliary colic. After worm emesis, the clinical syndrome was improved. A review of literatures reveals that the complication supposed to be due to heavy ascaris infestation can be found in many systems, such as; 1) Hepatobiliary and pancreatic complication: ascariasis is the most common parasitic infestation that induces this complication. The most frequent presenting symptom was abdominal pain presumably from recurrent biliary colic, acute pancreatitis, ascending cholangitis, acalculous cholecystitis, obstructive jaundice and liver abscess. 2) GI tract and peritoneal complication: gut obstruction, perforation, peritonitis, peritoneal granuloma, subphrenic collection and acute appendicitis 3) Extra-gastrointestinal complication: pyothorax. This worm should be kept in mind when the patients presenting with hepatobiliary and pancreatic related symptoms especially abdominal pain have been encountered.