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- Title
Pancreatic-Biliary Ascariasis: Experience of 300 Cases.
- Authors
Sandouk, Fayez; Haffar, Samir; Zada, Mazen M.; Graham, David Y.; Anand, Bhupinderjit S.
- Abstract
Background: Infestation with <em>Ascaris lumbricoides</em> is seen worldwide. Recently, there has been much interest in the pancreatic-biliary complications of <em>Ascaris</em> infection. In this study, we present our experience of 300 patients seen in a tertiary referral center. Materials and Methods: Case charts of patients seen in the Department of Gastroenterology, University of Damascus, Syria, were analyzed, retrospectively, over a 5-yr period (September of 1988 to August of 1993). During this period, 1666 endoscopic retrograde cholangiopancreatographic studies were performed and pancreatic-biliary ascariasis was diagnosed in 300 patients (18%). Results: The most common presenting symptom was abdominal pain, seen in 98% of patients (294 patients). Complications observed were ascending cholangitis (48 patients; 16%), acute pancreatitis (13 patients; 4.3%), and obstructive jaundice (4 patients; 1.3%). History of worm emesis was present in 25% of patients (76 patients). Most patients (240 patients; 80%) had previously undergone a cholecystectomy or an endoscopic sphincterotomy (232 patients; 77%). Worms were successfully extracted endoscopically in all except two patients, and there were no procedure-related complications. Conclusions: in endemic countries, ascariasis should be suspected in patients with pancreatic-biliary disease, especially if a cholecystectomy or sphincterotomy has been performed in the past. Endoscopic management results in rapid resolution of symptoms and prevents development of complications.
- Publication
American Journal of Gastroenterology (Springer Nature), 1997, Vol 92, Issue 12, p2264
- ISSN
0002-9270
- Publication type
Academic Journal