Chen C H, Wong J M, Hwang Y T, Lin J T, Wang T H
Department of Internal Medicine, National Taiwan University Hospital, Taipei, R.O.C.
J Formos Med Assoc. 1994 May;93(5):437-90.
A 64-year-old female aborigine presented with acute cholangitis and obstructive jaundice for three days. Abdominal ultrasonography showed dilatation of the common bile duct, intrahepatic ducts and a linear tubular structure in the common bile duct. Duodenoscopy showed a live Ascaris protruding through the papilla of Vater, which was retracted endoscopically. Cholangitis improved dramatically after worm extraction and nasobiliary drainage. Endoscopic retrograde cholangiography revealed another worm retained in the common bile duct. It disappeared spontaneously from the common bile duct one week later. The barium study of the intestine showed multiple filling defects in the terminal ileum. A total of five worms passed into the stool after treatment with pyrantel pamoate.
一名64岁的女性原住民因急性胆管炎和梗阻性黄疸就诊，症状已持续三天。腹部超声检查显示胆总管、肝内胆管扩张，胆总管内有一线状管状结构。十二指肠镜检查发现一条活蛔虫从 Vater 乳头突出，经内镜将其退回。取出蛔虫并进行鼻胆管引流后，胆管炎显著改善。内镜逆行胆管造影显示胆总管内仍有另一条蛔虫。一周后，这条蛔虫自行从胆总管消失。肠道钡剂造影显示回肠末端有多个充盈缺损。使用吡喹酮治疗后，共有五条蛔虫随粪便排出。
