the patient is fed via nasogastric tube. When found in the gallbladder, an Ascaris lumbricoides infection most often requires a cholecystectomy.8 Once the patient reported here began antihelmintic therapy with mebendazol and metronidazol, there was spontaneous elimination of the ascaris from the gallbladder and the intestines. A diagnosis of ascaris-induced liver abscess and gall bladder ascariasis was rendered. © 2021 BioMed Central Ltd unless otherwise stated. Once the ascariasis diagnosis was established, he was given conservative treatment of magnesium sulfate with herbal medicine. 2019;9(1):175–9. 4,10 Laboratory data showed (Oct 3, 16. Hepatobiliary and pancreatic ascariasis. As suggested in the available literature, initial therapy for gallbladder ascariasis should involve conservative treatment, unless an associated disease is present or a complication arises, because some patients can be treated conservatively (Topal) (Gonen). Other drugs such as ivermectin (Stromectol), levamisole (Ergamisol), pyrantel pamoate (Pin Rid, Pin X), nitazoxanide, and piperazine citrate have also been used effectively. Misra MK, Singh S, Bhagat TS. The mobile, tubular structure was approximately 15 cm long, with a diameter of approximately 0.5 mm (Figure 1). https://doi.org/10.1007/s12262-012-0527-3. Three days later, US showed the Ascaris in the main hepatic duct; after another 4 days, the worm had disappeared from the biliary tree. On physical examination, we found him moderate nutrition, moderate subcutaneous lipid barrier, medium body size, yellowish skin tone, slightly lower skin temperature, slightly dry skin, red tongue with pale yellow fur, mild yellow staining of the sclera, no yellow staining of the skin and mucous membranes. Women’s Health Res. The intestinal roundworm Ascaris lumbricoides is a cylindrical nonsegmented worm measuring 15 to 40 cm long.1 Roughly 25% of the world’s population is believed to be infected by this worm.2 Infection is primarly spread through poor sanitation and bad hygienic conditions.2 The adult form lives primarily in the small intestine (99%), duodenum, stomach, gallbladder, and ductus pancreaticus.3, Each worm can produce approximately 200,000 eggs daily. Saudi J Gastroenterol. Gallbladder ascaris: Presentation and management. Google Scholar. The early combined treatment can help to optimize management and avoid the preventable complications of GA. Based on syndrome differentiation, the herbal medicine treatment has applicability and curative effect; which indicate liver-protecting, choleretic, anti-inflammatory and open obstruction effect. However, this may be accounted for by the treatment given outside. single-dose albendazole (Albenza) or mebendazole (Vermox) are drugs of choice for ascariasis. 1999;86:1526–7. Five patients with acute J Med Pharm Chin Minor. A 4-year-old Uyghur boy with a history of ascariasis developed intermittent upper abdominal pain for 7 days, was being treated by a local practitioner, and when the pain worsened with yellow sclera for 3 days, he was admitted to our … https://doi.org/10.16041/j.cnki.cn15-1175.2011.04.009. The purpose of the combined treatment is to protect the liver, promote the contraction of the gallbladder, change the suitable environment for Ascaris survival, and eliminate it [23,24,25,26]. Journal of Medical Case Reports If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. During this period, the stool was examined daily for … 4, 6 This may not hold true for gallbladder ascariasis. Also recover the liver function by anti-inflammation, cholagogue, diuresis and relieving pain effects [23,24,25,26,27,28,29]. Worms within the biliary tract are not killed by the anti-helminthic drugs. The infection of the gallbladder with Ascaris lumbricoides is not frequent, but ultrasonography screening can be the key diagnostic tool in the diagnosis and evaluation of response to treatment. Cite this article. Other test results were urine specific gravity 1.015, pH 6.0, albumin negative, blood nil, red blood cell (RBC), casts, crystals were nil, bacteria (−) reported. California Privacy Statement, They also received symptomatic therapy for gastroenteritis. Xanthogranulomatosis is defined as the presence of chronic inflammatory cells, namely, lymphocytes and plasma cells along with foamy, lipid-laden macrophages. Cookies policy. The boy had a history of roundworm disease nearly a year ago and recovered after a combination treatment with pumpkin seeds and anti-ascaris drugs. Health care providers administer drugs for only about one to three days. World J Gastroenterol. All authors read and approved the final manuscript. A fever caused by another disease or the use of some medication, ie tetrachloretilen, can provoke such migration.3, The infection with Ascaris lumbricoides is diagnosed by identifying the characteristic eggs in the stool of the infected person. Treatment. All data used during the present study are available from the corresponding author on reasonable request. Ibrarullah M, Mishra T, Dash AP, et al. Ozmen MN, Oguzkurt L, Ahmet B, et al. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Israyil, Z., Gul, A., Memtily, N. et al. b There was no abnormal gallbladder size, and no abnormal echo in it, suggested no ascariasis in it. Article  Turk J Gastroenterol. On physical examination, found out the patient with yellowish skin tone, pale yellow fur on tongue, mild yellow staining of the sclera and tenderness in epigastrium. The causative agent is Ascaris lumbricoides. They can be seen on ultrasonography, mostly by accident. Adult worms can penetrate the small intestine and spread to the heart and lungs through the circulation. The follow up monitoring of the patient was carried out. Javid G, Wani N, Gulzar GM, et al. Treatment of 20 cases of fatty liver with TUM Sirkenjibin buzuri. 1b). In this patient, epigastric and right upper quadrant pain with yellow sclera was the main symptom, which is considered to be due to the acute cholecystitis. Contrary to our expectations, there was moderate biliary tree dilatation in this case. ZI, AG, and NM prepared the clinical information and wrote the manuscript. https://doi.org/10.1007/s12262-012-0527-3, https://www.cdc.gov/parasites/ascariasis/, https://doi.org/10.16041/j.cnki.cn15-1175.2011.04.009, https://doi.org/10.16041/j.cnki.cn15-1175.2011.06.009, https://doi.org/10.16041/j.cnki.cn15-1175.2014.01.011, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s13256-020-02571-x. Other test results were urine specific gravity 1020, pH 6.5, protein nil, blood nil, pus cells nil, cast nil, crystals nil, bacteria nil, patient was evaluated clinically and BP was 90/60 mm Hg, no lumber pain, no edema, urine output was normal all other complains were also normal. Privacy 2011;4:9–10. need anthelminthic treatment [1]. The worm can enter the biliary tree from the duodenum and causes variable symptoms such as biliary colic and obstructive jaundice [1, 2]. 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