Azhar Muhammad, Sheikh Ali Sibtain Farooq, Khan Asim, Mustafa Saqib, Shah Imran Ali, Hameed Bilal
J Ayub Med Coll Abbottabad. 2015 Apr-Jun;27(2):479-81.
Ascaris lumbricoides is the commonest organism causing soil-transmitted helminth infection. It is particularly common in poor sanitary conditions. Nevertheless, involvement of the gallbladder by Ascaris is a rare entity. A lady presented to us with long-standing history of vague abdominal symptoms suggesting dyspepsia. Ultrasound showed a tube like structure invading the biliary channels. Serum amylase was elevated and the patient was managed conservatively, as for acute pancreatitis. She improved clinically, but subsequent imaging with magnetic resonance cholangiopancreatography revealed worm in the gallbladder. Laparoscopic cholecystectomy was done and Ascaris lumbricoides was removed. Ascaris infestation is an important differential diagnosis of patients with upper abdominal symptoms and screening with stool examination and ultrasound is warranted in high-risk population.
蛔虫是引起土壤传播蠕虫感染最常见的病原体。在卫生条件差的地区尤为常见。然而，蛔虫累及胆囊是一种罕见情况。一位女士因长期存在提示消化不良的模糊腹痛症状前来就诊。超声显示一个管状结构侵入胆管。血清淀粉酶升高，患者按急性胰腺炎进行保守治疗。她的临床症状有所改善，但随后的磁共振胰胆管造影成像显示胆囊内有蛔虫。遂行腹腔镜胆囊切除术，取出了蛔虫。蛔虫感染是有上腹部症状患者的重要鉴别诊断，高危人群有必要通过粪便检查和超声进行筛查。
