Biliary ascariasis – A vicious cycle

Biliary ascariasis is a rare disease in a non-endemic area. However, it is one of the possible etiological factors for retarded growth as well as malnutrition in children. It may cause intestinal obstruction, appendicitis, biliary obstruction, liver abscess, hepatolithiasis, and pancreatitis in adults. Herein, we report a patient with ascending cholangitis secondary to biliary ascariasis who was successfully managed with Endoscopic Retrograde Cholangio Pancreaticography.

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Surgical Ascariasis in Children in Kashmir

Tropical Doctor ◽

10.1177/004947559702700107 ◽

1997 ◽

Vol 27 (1) ◽

pp. 13-14 ◽

Cited By ~ 10

Author(s):

Satish Kumar Pandit ◽

Habib Ullah Zarger

Keyword(s):

Retrospective Study ◽

Intestinal Obstruction ◽

Endemic Area ◽

Surgical Intervention ◽

Ileal Perforation ◽

Biliary Ascariasis ◽

High Incidence ◽

Surgical Conditions

A retrospective study of 85 children aged 3–12 years revealed 25 cases who needed surgical intervention due to ascariasis. The surgical conditions found at laparotomy were intestinal obstruction (18) appendicitis (3), ileal perforation (2), biliary ascariasis (2). The study highlights the high incidence of surgical ascariasis among children with abdominal complaints in an endemic area.

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Pancreatic-Biliary Ascariasis in an Infant

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v37i1.16501 ◽

2017 ◽

Vol 37 (1) ◽

pp. 98-100

Author(s):

Kakali Roy ◽

Joydeep Das ◽

Devdeep Mukherjee ◽

Ritabrata Kundu

Keyword(s):

Biliary Obstruction ◽

Endemic Area ◽

Average Diameter ◽

Paediatric Population ◽

Biliary Ascariasis ◽

Round Worm

Ascaris infestation that too causing biliary obstruction is very rare in infancy even in endemic area. Adult Ascaris diameter (3-6 mm) is more than the average diameter of CBD in paediatric population, which is 1.27 +/- 0.67 mm. We are reporting a baby of seven months who presented with conjugated hypebilirubinemia and pancreatitis due to Round Worm in CBD.

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Faculty Opinions recommendation of Urgent endoscopic retrograde cholangiopancreatography is not superior to early ERCP in acute biliary pancreatitis with biliary obstruction without cholangitis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.732604646.793546992 ◽

2018 ◽

Author(s):

Matthew DiMagno

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

Biliary Obstruction ◽

Biliary Pancreatitis ◽

Endoscopic Retrograde ◽

Acute Biliary Pancreatitis

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Are complications of endoscopic sphincterotomy age related?

Gut ◽

10.1136/gut.41.4.545 ◽

1997 ◽

Vol 41 (4) ◽

pp. 545-548 ◽

Cited By ~ 42

Author(s):

G T Deans ◽

P Sedman ◽

D F Martin ◽

C M S Royston ◽

C K Leow ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Endoscopic Sphincterotomy ◽

Short Term ◽

Endoscopic Retrograde ◽

Younger Patients ◽

Age Related ◽

Increased Risk ◽

Ascending Cholangitis ◽

Retroperitoneal Perforation ◽

The Common

Background—Endoscopic retrograde cholangiopancreatography sphincterotomy is increasingly performed in younger patients undergoing laparoscopic cholecystectomy. However, the safety of endo- scopic sphincterotomy in this age group, relative to that in older patients, is unknown.Aim—To determine whether the development of short term complications following endoscopic sphincterotomy is age related.Patients and methods—A prospective multicentre audit of 958 patients (mean age 73, range 14–97, years) undergoing a total of 1000 endoscopic sphincterotomies.Results—Two deaths occurred, both from postsphincterotomy acute pancreatitis. Postprocedural complications developed in 24 patients: pancreatitis in 10, ascending cholangitis in seven, bleeding in four, and retroperitoneal perforation in three. There were six complications (five cases of pancreatitis and one bleed; 2.2%) and no deaths in the 281 (29.3%) patients aged under 65 years. In comparison, 18 (2.6%) of the 677 patients aged over 65 years developed a complication (cholangitis in seven, pancreatitis in five, bleeding in three, and perforation in three). Patients under 35, 45, 55, and 65 years were not at significantly increased risk of complication than those over these ages (relative risk for those under compared with those over 65 years 0.83, 95% confidence intervals 0.41–1.67, p=0.74).Conclusion—Short term complications following endoscopic sphincterotomy are not related to age. Younger patients undergoing laparoscopic cholecystectomy need not be denied endoscopic sphincterotomy for fear that the risks are greater than if they undergo surgical exploration of the common bile duct.

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Optimal timing of endoscopic retrograde cholangiopancreatography for acute cholangitis associated with distal malignant biliary obstruction

BMC Gastroenterology ◽

10.1186/s12876-021-01755-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Namyoung Park ◽

Sang Hyub Lee ◽

Min Su You ◽

Joo Seong Kim ◽

Gunn Huh ◽

...

Keyword(s):

Mortality Rate ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Biliary Obstruction ◽

Acute Cholangitis ◽

Mortality Rates ◽

Malignant Biliary Obstruction ◽

Optimal Timing ◽

Endoscopic Retrograde ◽

The Difference ◽

Distal Malignant Biliary Obstruction

Abstract Background There is a lack of studies regarding the optimal timing for endoscopic retrograde cholangiopancreatography (ERCP) in patients with cholangitis caused by distal malignant biliary obstruction (MBO). This study aims to investigate the optimal timing of ERCP in patients with acute cholangitis associated with distal MBO with a naïve papilla. Methods A total of 421 patients with acute cholangitis, associated with distal MBO, were enrolled for this study. An urgent ERCP was defined as being an ERCP performed within 24 h following emergency room (ER) arrival, and early ERCP was defined as an ERCP performed between 24 and 48 h following ER arrival. We evaluated both 30-day and 180-day mortality as primary outcomes, according to the timing of the ERCP. Results The urgent ERCP group showed the lowest 30-day mortality rate (2.2%), as compared to the early and delayed ERCP groups (4.3% and 13.5%) (P < 0.001). The 180-day mortality rate was lowest in the urgent ERCP group, followed by early ERCP and delayed ERCP groups (39.4%, 44.8%, 60.8%; P = 0.006). A subgroup analysis showed that in both the primary distal MBO group, as well as in the moderate-to-severe cholangitis group, the urgent ERCP had significantly improved in both 30-day and 180-day mortality rates. However, in the secondary MBO and mild cholangitis groups, the difference in mortality rate between urgent, early, and delayed ERCP groups was not significant. Conclusions In patients with acute cholangitis associated with distal MBO, urgent ERCP might be helpful in improving the prognosis, especially in patients with primary distal MBO or moderate-to-severe cholangitis.

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Surgical management of cystic dilatation bile ducts in adults

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202015000100005 ◽

2015 ◽

Vol 28 (1) ◽

pp. 17-19

Author(s):

Olival Cirilo Lucena da FONSECA-NETO ◽

Moacir Cavalcante de ALBUQUERQUE-NETO ◽

Antonio Lopes de MIRANDA

Keyword(s):

Magnetic Resonance Imaging ◽

Rare Disease ◽

Biliary Tract ◽

Bile Ducts ◽

Adult Population ◽

Ultrasound Scanning ◽

Resonance Imaging ◽

Cystic Dilatation ◽

Initial Examination ◽

Endoscopic Retrograde

BACKGROUND: The cystic dilatation of the biliary tract is a rare disease and uncertain origin. It is recognized more frequently in children; however, its incidence comes increasing in adults, representing 20% of the cases. AIM: To evaluate morbimortality rates, evolution and handing of patients with cystic dilatation bile ducts in adults. METHODS: Were evaluated, retrospectively, five adults who had the diagnosis of choledochal cyst and that had been submitted to some surgical procedure. RESULTS: Abdominal pain was the commonest complain to all patients. Jaundice was present in 80%. Ultrasound scanning was done in all the cases as initial examination. CT scan, magnetic resonance imaging and endoscopic retrograde cholangiopancreatography were also done in some patients; however, the diagnosis was established intra-operatively in all cases. The cyst resection with reconstruction of the biliary tract was done in 60%; the cystojejunostomy in 20%; and in 20% biliary tract drainage. CONCLUSIONS: Biliary tract cystic dilatation is a rare disease. However, its incidence is increasing in the adult population, so, it must be thought as differential diagnosis when facing obstructive jaundice.

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Ruptured Liver Abscess in Neonates: Report of Two Cases

Journal of Neonatal Surgery ◽

10.21699/jns.v5i3.335 ◽

2016 ◽

Vol 5 (3) ◽

pp. 31 ◽

Cited By ~ 1

Author(s):

Niyaz Ahmed Khan ◽

SR Choudhury ◽

Praveen Jhanwar

Keyword(s):

Rare Disease ◽

Liver Abscess ◽

Abdominal Mass ◽

Hepatic Abscess ◽

Predisposing Factor ◽

Term Neonates ◽

Umbilical Catheterisation

Neonatal hepatic abscess is a rare disease seen mainly in preterm following umbilical catheterisation. Liver abscess in term neonates without any predisposing factor is still rarer and only few cases have been reported in the literature. Here we report two cases of liver abscess in term neonates presenting with abdominal mass due to rupture.

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