Rana Surinder Singh, Bhasin Deepak Kumar, Nanda Mohit, Singh Kartar
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, 1041, Sector 24-B, Chandigarh 160 023, India.
Curr Gastroenterol Rep. 2007 Apr;9(2):156-64. doi: 10.1007/s11894-007-0011-6.
Parasitic infestations of the biliary tract are a common cause of biliary obstruction in tropical countries and can lead to such serious complications as cholangitis and cholangiocarcinoma. Endoscopic therapy has helped in the management of biliary complications caused by these parasites. Ascaris lumbricoides organisms, which normally reside in the jejunum, are actively motile and can invade the papilla, thus migrating into the bile duct and causing biliary obstruction. Endoscopic retrograde cholangiopancreatography is a useful diagnostic tool with potential for therapeutic management of biliary ascariasis. Infestation with Clonorchis sinensis organisms can cause such complications as intrahepatic stones, recurrent pyogenic cholangitis, cirrhosis, cholelithiasis, pancreatitis, and cholangiocarcinoma. Opisthorchis viverrini, Opisthorchis felineus, and Dicrocoelium dendriticum are closely related to C. sinensis and can also cause serious biliary complications. Fascioliasis, caused by Fasciola hepatica and F. gigantica, is a zoonotic helminthiasis that can present as acute hepatic or chronic biliary tract infection. CT, MRI, and ultrasound guidance are useful imaging tools for identifying these parasites and their complications.
在热带国家，胆道寄生虫感染是胆道梗阻的常见原因，可导致胆管炎和胆管癌等严重并发症。内镜治疗有助于处理由这些寄生虫引起的胆道并发症。蛔虫通常寄居于空肠，活动活跃，可侵入乳头，进而迁移至胆管并导致胆道梗阻。内镜逆行胰胆管造影术是一种有用的诊断工具，对胆道蛔虫病具有治疗管理潜力。华支睾吸虫感染可导致肝内结石、复发性化脓性胆管炎、肝硬化、胆石症、胰腺炎和胆管癌等并发症。猫后睾吸虫、麝猫后睾吸虫和枝双腔吸虫与华支睾吸虫密切相关，也可导致严重的胆道并发症。由肝片吸虫和巨片吸虫引起的肝片吸虫病是一种人畜共患的蠕虫病，可表现为急性肝感染或慢性胆道感染。CT、MRI和超声引导是识别这些寄生虫及其并发症的有用影像学工具。
