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- Title
Mummified Ascaris in Calculus Gallbladder: a Rare Case Report.
- Authors
Anwer, Majid; Kumar, Anil; Uddin, Masleh; Ahmed, Farheen
- Abstract
Ascaris lumbricoides is the most common parasite of the gastrointestinal tract. On many occasions, it may pass via the ampulla of vater to reach the common bile duct, but its existence in the gallbladder is very rare. We describe a rare case where it reached the gallbladder and got mummified. A 45-year-old lady presented with pain in right upper quadrant of the abdomen for 2 months, which was associated with nausea. An ultrasonography abdomen was done, which showed multiple calculi of varying size in the gallbladder lumen. There was also evidence of a large, curved, and anechoic structure noted within the lumen of the gallbladder, suggestive of gallbladder ascariasis. A diagnosis of biliary ascariasis with cholelithiasis was made, and laparoscopic cholecystectomy was done. The postoperative specimen showed clumped mummified Ascaris lumbricoides with pigmented stone. She was discharged on 3rd postoperative day and doing well on 3rd month of follow-up. Gallbladder ascariasis is a rare presentation, and few cases are reported in the literature. The usual presentations are acute acalculus cholecystitis and empyema gallbladder. Rarely Ascaris lumbricoides can undergo mummification and be associated with gallstones. Ultrasound is the investigation of choice, which shows long, non-posterior acoustic shadowing tubular structure. Conservative management with antihelminthic drugs is preferred in acalculus cholecystitis, but operative intervention, preferably laparoscopic cholecystectomy or exploratory laparotomy, is the ideal treatment for the ascariasis gallbladder with calculus cholecystitis.
- Subjects
BILIOUS disease diagnosis; GALLSTONE diagnosis; GALLSTONES; PHYSICAL diagnosis; ULTRASONIC imaging; LAPAROSCOPIC surgery; POSTOPERATIVE care; CHOLECYSTECTOMY; TREATMENT effectiveness; INTESTINAL parasites; COLLECTION &; preservation of biological specimens; BLOOD testing; ASCARIASIS; AMIDES
- Publication
Indian Journal of Surgery, 2023, Vol 85, Issue 5, p1278
- ISSN
0972-2068
- Publication type
Article
- DOI
10.1007/s12262-023-03673-8