Korean Journal of Gastrointestinal Endoscopy 1993;13(3): 573-576.
총수담관 결석을 동반한 담도 회충미입증의 내시경적 치료 1예 ( Endoscopic Treatment of Biliary Ascariasis with a Common Bile Duct Stone - A case report - )
정일건, 김창섭, 김승준, 오기원, 김재광, 김성훈, 정인식 (Il Gun Chung, Chang Seop Kim, Seung Joon Kim, Ki Won Oh, Jae Kwang Kim, Sung Hoon Kim and In Sik Chung)
Abstract
Biliary ascariasis is a rare complication of intestinal ascaris infestation. Retrograde migration of the adult worm through the papilla of Vater causes biliary colic, and may give rise to pancreatic and biliary obstruction, choledocholithiasis, cholecystitis, cholangitis, hemobilia, and if the worm lodges in intrahepatic bile ducts, to liver absceases. In the past, treatment of biliary ascariasis has usually involved the direct removal of ascaris throagh a surgical choledochatomy and subsequent saline lavage of the common duct through an indwelling T tube. Recently, the worm in the bile duct can be seen by ERCP and it can be removed during the endoscopic procedure. A 55-year-old woman with intermittent colicky right upper quadrant abdominal pain was admitted to out hospital. Abdominai sonogram disclosed an echogenic structure within a mildly dilated common bile duct and a high ehogenic structure with acoustic shadowing in the distal common bile duct(CBD), which suggests a CBD stone. ERCP after obtaining the sonogram revealed a thick, long, linear, smooth filling defect in the CBD with a distal CBD stone. A distal CBD stone was removed by sphinctetotomy and lithotripsy, then we directly extracted ascaris with a tripod forcep without any complication.
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