Hepatobiliary and pancreatic ascariasis

Hepatobiliary and pancreatic ascariasis(HPA) was described as a clinical entity from Kashmir,India in 1985. HPA is caused by invasion and migration of nematode,Ascaris lumbricoides,in to the biliary tract and pancreatic duct. Patients present with biliary colic,cholangitis,cholecystitis,hepatic absc...

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Published inWorld journal of gastroenterology : WJG Vol. 22; no. 33; pp. 7507 - 7517
Main Authors Khuroo, Mohammad S, Rather, Ajaz A, Khuroo, Naira S, Khuroo, Mehnaaz S
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 07.09.2016
Subjects
Algorithms
Animals
Ascariasis - complications
Ascariasis - diagnosis
Ascaris
Ascaris lumbricoides
Biliary Tract - pathology
Biliary Tract Diseases - complications
Biliary Tract Diseases - diagnosis
calculi;Cholangitis;Pancreatitis;Recurrent
cholangitis
Cholangitis - complications
Cholangitis - diagnosis
Cholecystitis - complications
Cholecystitis - diagnosis
Humans
India
Liver Diseases, Parasitic - complications
Liver Diseases, Parasitic - diagnosis
lumbricoides;Cholecystitis;Biliary
Minireviews
Pancreatitis - complications
Pancreatitis - diagnosis
Prevalence
pyogenic
Ascaris lumbricoides
Recurrent pyogenic cholangitis
Cholecystitis
Biliary calculi
Cholangitis
Pancreatitis
Online AccessGet full text
ISSN1007-9327
2219-2840
2219-2840
DOI10.3748/wjg.v22.i33.7507

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Summary:Hepatobiliary and pancreatic ascariasis(HPA) was described as a clinical entity from Kashmir,India in 1985. HPA is caused by invasion and migration of nematode,Ascaris lumbricoides,in to the biliary tract and pancreatic duct. Patients present with biliary colic,cholangitis,cholecystitis,hepatic abscesses and acute pancreatitis. Ascarides traverse the ducts repeatedly,get trapped and die,leading to formation of hepatolithiasis. HPA is ubiquitous in endemic regions and in Kashmir,one such region,HPA is the etiological factor for 36.7%,23%,14.5% and 12.5% of all biliary diseases,acute pancreatitis,liver abscesses and biliary lithiasis respectively. Ultrasonography is an excellent diagnostic tool in visualizing worms in gut lumen and ductal system. The rational treatment for HPA is to give appropriate treatment for clinical syndromes along with effective anthelmintic therapy. Endotherapy in HPA is indicated if patients continue to have symptoms on medical therapy or when worms do not move out of ductal lumen by 3 wk or die within the ducts. The worms can be removed from the ductal system in most of the patients and such patients get regression of symptoms of hepatobiliary and pancreatic disease.
Bibliography:Mohammad S Khuroo;Ajaz A Rather;Naira S Khuroo;Mehnaaz S Khuroo;Sher-I-Kashmir Institute of Medical Sciences;Digestive Diseases Centre,Dr. Khuroo’s medical Clinic;Department of Surgery,SKIMS Medical College and Hospital;Consultant Radiology,Digestive Diseases Centre,Dr. Khuroo’s Medical Clinic;Department of Pathology,Govt. Medical College
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Author contributions: All authors contributed equally; Rather AA, Khuroo NS and Khuroo MS made literature search; Khuroo NS conducted the radiological studies and critically reviewed the images; Khuroo MS and Khuroo NS wrote the paper; all authors read the paper and made necessary corrections.
Correspondence to: Mohammad S Khuroo, Director, Digestive Diseases Centre, Dr. Khuroo’s Medical Clinic, Sector 1, SK Colony, Qamarwari, Srinagar, Kashmir 190010, India. khuroo@yahoo.com
Telephone: +91-194-2492398 Fax: +91-194-2491190
Supported by Dr. Khuroo’s Medical Trust, a nonprofit organization which supports academic activities, disseminates medical education and helps poor patients for medical treatment.
ISSN:1007-9327
2219-2840
2219-2840
DOI:10.3748/wjg.v22.i33.7507