Chakrabarti Indranil, Giri Amita, De Anuradha, Roy Asit Chandra
Departments of Pathology, North Bengal Medical College, Darjeeling, India.
J Cytol. 2011 Jul;28(3):114-6. doi: 10.4103/0970-9371.83468.
Ascariasis is the commonest helminthic infection in humans, caused by the nematode Ascaris lumbricoides. The adult worms usually reside in the small intestine. Rarely, they migrate into the bile duct and pancreatic ducts, but involvement of the gall bladder and/or liver parenchyma is extremely rare. Here, we describe a case of a 32-year-old woman who presented with fever, anorexia, right upper quadrant pain and mild hepatomegaly. Ultrasonography revealed a liver abscess and a concurrent moving adult worm in the gall bladder. Fine-needle aspiration cytology (FNAC) from the liver abscess showed presence of fertilized eggs of Ascaris lumbricoides. A diagnosis of gall bladder and hepatic ascariasis was made. The patient responded well to conservative management. Ascaris-induced liver abscess with concurrent living adult worm in gall bladder has rarely been reported. Ultrasonography and FNAC are important diagnostic modalities for detection of such lesions. Conservative management appears to be the treatment of choice for hepatobiliary ascariasis.
蛔虫病是人类最常见的蠕虫感染，由线虫蛔虫引起。成虫通常寄生于小肠。它们很少迁移到胆管和胰管，但累及胆囊和/或肝实质极为罕见。在此，我们描述一例32岁女性患者，她出现发热、厌食、右上腹疼痛和轻度肝肿大。超声检查发现肝脓肿，同时胆囊内有一条活动的成虫。肝脓肿细针穿刺细胞学检查（FNAC）显示存在蛔虫受精卵。诊断为胆囊和肝蛔虫病。患者对保守治疗反应良好。蛔虫引起的肝脓肿同时胆囊内有活的成虫鲜有报道。超声检查和FNAC是检测此类病变的重要诊断方法。保守治疗似乎是肝胆蛔虫病的首选治疗方法。
