Thandassery Ragesh Babu, Jha Ashish Kumar, Goenka Mahesh Kumar
Consultant in Gastroenterology, Institute of Gastrointestinal Sciences, Apollo Gleneagles Hospital, Kolkata, India.
Trop Doct. 2014 Apr;44(2):108-9. doi: 10.1177/0049475513518199. Epub 2014 Jan 9.
Endoscopic retrograde cholangiography is the most commonly used technique for removal of common bile duct stones. Biliary sphincterotomy during the procedure facilitates stone retrieval from the common bile duct. However, sphincterotomy ablates the normal biliary sphincter mechanism. This facilitates duodeno-biliary reflex and can result in inward migration of luminal parasite into the biliary system. In areas where ascariasis is endemic there is an increased risk of biliary ascariasis in postbiliary sphincterotomy patients. We report an unusual case where a patient presented with recurrent biliary colic after cholecystectomy and common bile duct stone extraction and was diagnosed to have biliary ascariasis with the help of endoscopic ultrasound examination of the biliary system.
内镜逆行胆管造影术是最常用于清除胆总管结石的技术。该手术过程中的胆管括约肌切开术有助于从胆总管取出结石。然而，括约肌切开术会破坏正常的胆管括约肌机制。这会促进十二指肠-胆管反射，并可能导致腔内寄生虫向胆道系统内迁移。在蛔虫病流行地区，胆管括约肌切开术后患者发生胆道蛔虫病的风险增加。我们报告了一例不寻常的病例，一名患者在胆囊切除和胆总管结石取出术后出现复发性胆绞痛，经胆道系统内镜超声检查被诊断为胆道蛔虫病。
