Khuroo M S, Zargar S A, Yattoo G N, Dar M Y, Javid G, Khan B A, Boda M I, Mahajan R
Department of Gastroenterology, Institute of Medical Sciences, Srinagar, Kashmir, India.
J Clin Ultrasound. 1992 Nov-Dec;20(9):587-91. doi: 10.1002/jcu.1870200904.
Invasion of the adult roundworm, Ascaris lumbricoides, into the gallbladder is rare and was seen in 14(2.1%) of the 665 cases with hepatobiliary ascariasis. The diagnosis was suggested in all 13 cases in which sonography was performed and in 5 of the 11 cases at endoscopic retrograde cholangiography. Sonographic findings included a nonshadowing, long, echogenic structure in the form of a coil, an echogenic strip with central anechoic tube, an echogenic structure extending across the gallbladder giving it a septate appearance, and characteristic erratic, nondirectional, zig-zag movements of these echogenic structures in the gallbladder. Serial sonograms accurately predicted spontaneous exit of the worm. Pregnancy and anomalous origin of the cystic duct directly from the papilla of Vater facilitated worm invasion into the gallbladder. We conclude that real-time sonography offers a simple, rapid approach for the diagnosis and follow-up of patients, whereas endoscopic retrograde cholangiography has limited diagnostic value in this disorder.
成人蛔虫（蛔虫）侵入胆囊的情况较为罕见，在665例肝胆蛔虫病患者中有14例（2.1%）出现这种情况。在所有进行超声检查的13例病例以及11例经内镜逆行胆管造影检查的病例中有5例提示了该诊断。超声检查结果包括呈盘绕状的无回声、长的、回声增强结构，中央为无回声管的回声增强条带，横跨胆囊的回声增强结构使其呈现分隔外观，以及这些回声增强结构在胆囊内特征性的不规则、无定向、之字形运动。连续超声检查能准确预测蛔虫自行排出。妊娠以及胆囊管直接起自 Vater 乳头的异常起源促使蛔虫侵入胆囊。我们得出结论，实时超声检查为患者的诊断和随访提供了一种简单、快速的方法，而经内镜逆行胆管造影在这种疾病中的诊断价值有限。
