van Severen M, Lengele B, Dureuil J, Shapira M, Dive C
Endoscopy. 1987 May;19(3):140-2. doi: 10.1055/s-2007-1018261.
Adult Ascaris, which are usually found in the intestine, can enter the ampulla of Vater if the sphincter of Oddi is not efficient. This situation seems common in children; in adults it occurs after endoscopic or surgical sphincterotomy. The worms can then migrate up into the intrahepatic bile ducts and provoke biliary stasis which may become infected and complicated by abscesses. It is inside such abscesses that we may find fragments of adult Ascaris. In the 4 cases reported in the literature during the last 20 years, we note in particular that the clinical signs vary considerably, according to the age of the patient. In children, the parasitic infestation is often massive and the clinical features are extremely serious, namely shock and acute abdominal pain, which lead to a laparotomy being done. In adults, the clinical feature is that of a biliary infection. Here we describe a fifth case of hepatic ascaridiasis which differs from the others in that the diagnosis was established by ERCP and CT scan and that treatment was medical.
成虫蛔虫通常寄生于肠道，若奥迪括约肌功能不全，蛔虫可进入 Vater 壶腹。这种情况在儿童中似乎很常见；在成人中，它发生在内镜或手术括约肌切开术后。然后，蛔虫可向上迁移至肝内胆管，引发胆汁淤积，进而可能被感染并并发脓肿。正是在这类脓肿中，我们可能会发现成虫蛔虫的碎片。在过去 20 年文献报道的 4 例病例中，我们特别注意到，根据患者年龄不同，临床症状差异很大。在儿童中，寄生虫感染往往很严重，临床特征极其严重，即休克和急性腹痛，这导致需要进行剖腹手术。在成人中，临床特征是胆道感染。在此，我们描述第五例肝蛔虫病病例，该病例与其他病例不同之处在于，其诊断是通过 ERCP 和 CT 扫描确立的，且治疗采用药物治疗。
