Biliary Ascariasis

Abstract

One quarter of world’s population is known to be affected by ascariasis. It is endemic in various parts of the subcontinent. Gangetic plain of Bangladesh, West Bengal, Kashmere valley are examples. Biliary ascaiasis is one of the manifestations of ascariasis. We searched literature published from both endemic and non-endemic area and aimed to study different types of clinical presentation, diagnostic tool, complications and their frequency and various treatment option for the management of biliary ascariasis. Biliary colic is the commonest symptom. Acute cholecystitis, obstructive jaundice, cholangitis, pancreatitis, hepatolithiasis, liver abscess are other mode of presentation. Ultrasonography is an excellent non –invasive investigation for diagnosis and follow up of this condition. Majority of cases are treated conservatively. ERCP (Endoscopic Retrograde Cholangio Pancreatography) based extraction of Ascaris lubricoids is possible in most of the situation where expert endoscopy services are available. Open common bile duct exploration and removal of worm is necessary in absence of endoscopy. Improvement of personal hygiene, improvement of sanitation and regular anti-helminthic administration can reduce this dreadful consequence of infestation by worms.