Case report
Gallbladder Ascariasis in a Young Adult: Not that Scary After All
PD07-PD09
Correspondence
Dr. Raja Kumaran Rajamanickam,
44E, Pocket F, GTB Enclave, Dilshad Garden, New Delhi-110095, India.
E-mail: rajathesurgeon@gmail.com
Hepatobiliary and Pancreatic Ascariasis (HPA) is an uncommon manifestation of Ascariasis. Hereby, authors report a case of a 35-year-old female who presented with two days of acute onset epigastric pain. It was associated with nausea and non bilious emesis. She had a similar episode about a week back that spontaneously subsided. The abdominal examination was benign and non contributory. Laboratory reports showed raised serum amylase and lipase levels, with other biochemical parameters within normal limits. She had no eosinophilia. Transabdominal Ultrasonography (USG) picked up a moving linear hyperechoic structure within the gallbladder with a bulky heterogeneous pancreas. The stool sample confirmed the presence of a fertilised Ascaris lumbricoides egg. The patient was admitted with the diagnosis of mild acute interstitial pancreatitis secondary to gallbladder and intestinal ascariasis. She was followed with serial abdominal scans, and on the third day, she had a spontaneous expulsion of the worm from the gallbladder. She was treated with a single dose of oral albendazole. She was later discharged on day six of admission in a stable condition. In endemic areas, patients presenting with hepatobiliary and pancreatic symptoms should consider ascariasis in the differential diagnosis. The management is largely non operative, with good clinical outcomes when diagnosed early. Efforts should be made to reduce the burden of ascariasis in the community with a focus on public health awareness.