Pereira-Lima J C, Jakobs R, da Silva C P, Coral G P, Da Silveirea L L, Rynkowski C B, Riemann J F
Department of Gastroenterology of the Santa Casa University Hospital, Porto Alegre School of Medical Sciences (FFFCMPA), Porto Alegre, Brazil.
Z Gastroenterol. 2001 Sep;39(9):793-6. doi: 10.1055/s-2001-17189.
Ascariasis is the most common intestinal helminthiasis worldwide. Heavily infected individuals are prone to develop bowel obstruction or perforation as well as biliary disease. Nevertheless, the presence of roundworms in the biliary tree outside endemic areas is very uncommon. The migration of these worms to the biliary system can cause biliary colic, pancreatitis, or even acute suppurative cholangitis with hepatic abscesses and septicemia. We report here on 2 infants with 14 and 15 months and a 9-year-old boy who suffered from massive biliary ascariasis and who presented with acute suppurative cholangitis. All cases were successfully treated by endoscopic retrograde cholangiopancreatography with worm extraction and adjuvant medical therapy. Physicians should be aware of ascariasis in patients with pancreatobiliary symptoms who have traveled to endemic areas or in immigrants from these areas.
蛔虫病是全球最常见的肠道蠕虫病。重度感染者易发生肠梗阻或穿孔以及胆道疾病。然而，在非流行地区的胆道系统中出现蛔虫非常罕见。这些蠕虫迁移至胆道系统可导致胆绞痛、胰腺炎，甚至急性化脓性胆管炎并伴有肝脓肿和败血症。我们在此报告2例分别为14个月和15个月大的婴儿以及1名9岁男孩，他们患有严重的胆道蛔虫病并表现为急性化脓性胆管炎。所有病例均通过内镜逆行胰胆管造影术成功治疗，取出蛔虫并辅以药物治疗。对于有胰胆症状且去过流行地区的患者或来自这些地区的移民，医生应警惕蛔虫病。
