Rujeerapaiboon Natthapat, Kaewdech Apichat
Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand.
Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand
BMJ Case Rep. 2021 Mar 24;14(3):e239784. doi: 10.1136/bcr-2020-239784.
Acute cholangitis is a condition of bacterial infection following hepatobiliary tract obstruction, which signifies poor prognosis unless adequately drained. The most common cause of bile duct obstruction is choledocholithiasis, in contrast to parasitic infestation, a rare entity causing acute cholangitis nowadays. Therefore, we reported the case of a 68-year-old Thai man who presented with acute fever, intense right upper quadrant abdominal pain and jaundice for 2 days. His medical history was normal except for the history of intermittent biliary colic for a year. Endoscopic retrograde cholangiography was performed and demonstrated multiple, creamy-coloured roundworms coming out from the ampulla of Vater as well as a tubular filling defect in dilated common bile duct from cholangiography. He was diagnosed with acute cholangitis by biliary ascariasis and underwent endoscopic parasitic removal, which subsequently improved symptoms.
急性胆管炎是一种在肝胆管梗阻后发生的细菌感染性疾病，除非得到充分引流，否则预后不佳。胆管梗阻最常见的原因是胆总管结石，与寄生虫感染相反，如今寄生虫感染是导致急性胆管炎的罕见病因。因此，我们报告了一例68岁泰国男性病例，该患者出现急性发热、右上腹剧烈腹痛和黄疸2天。除了有一年间歇性胆绞痛病史外，他的病史无异常。进行了内镜逆行胆管造影，显示有多条乳白色蛔虫从十二指肠乳头排出，胆管造影还显示扩张的胆总管内有管状充盈缺损。他被诊断为胆道蛔虫病引起的急性胆管炎，并接受了内镜下寄生虫清除术，随后症状得到改善。
