Termos Salah, Alali Mohammad, Alkabbani Majd, AlDuwaisan Abdullah, Alsaleh Ahmad, Alyatama Khalifa, Hayati Hussein
Hepatobiliary and Transplant Unit, Department of Surgery, Al-Amiri Hospital, Kuwait City, Kuwait.
Case Rep Surg. 2017;2017:7167934. doi: 10.1155/2017/7167934. Epub 2017 Nov 26.
Biliary colic is a visceral pain caused by attempts of the gallbladder or bile duct to overcome the obstruction in the cystic duct or ampulla of Vater. Obstruction can be due to different etiologies such as stone, mass, worm, and rarely by mucus plug. We report the case of a 31-year-old gentleman who presented with recurrent biliary colic and weight loss. Work-up showed linear calcifications in the gallbladder extending to the common bile duct suggesting hepatobiliary ascariasis. Further investigations including stool analysis, upper endoscopy, endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP) did not support our provisional diagnosis. Laparoscopic cholecystectomy was performed. Histopathological finding was grossly ambiguous; a rope-like mucus plug resembling ascaris worm was noted. The patient's condition improved instantly after the procedure. To our knowledge, we are reporting the first case in the English literature describing this unique entity of symptomatic gallbladder disease to increase awareness and improve its management.
胆绞痛是一种内脏痛，由胆囊或胆管试图克服胆囊管或 Vater 壶腹的梗阻引起。梗阻可能由不同病因导致，如结石、肿块、蛔虫，黏液栓导致梗阻的情况较为罕见。我们报告一例 31 岁男性患者，该患者反复出现胆绞痛并伴有体重减轻。检查显示胆囊内有延伸至胆总管的线性钙化，提示肝胆蛔虫病。包括粪便分析、上消化道内镜检查、内镜超声检查（EUS）和内镜逆行胰胆管造影（ERCP）在内的进一步检查并不支持我们的初步诊断。遂进行了腹腔镜胆囊切除术。组织病理学检查结果非常不明确；发现了一个类似蛔虫的绳状黏液栓。手术后患者的病情立即得到改善。据我们所知，我们在英文文献中首次报道了这一独特的有症状胆囊疾病病例，以提高认识并改善其治疗。
