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Gastroenterology18 papers

Biliary ascariasis

Last edited: 4/15/2026

Overview

Biliary ascariasis occurs when Ascaris lumbricoides worms migrate into the biliary tree, leading to complications such as cholangitis and pancreatitis 1.

Diagnosis

  • Clinical presentation includes symptoms of cholangitis and pancreatitis.
  • Imaging studies (e.g., ultrasound, CT) are crucial for identifying worms in the biliary tree.
  • Endoscopic retrograde cholangiopancreatography (ERCP) is essential for visualizing and extracting worms 1.

    • Management

  • First-line treatment: Endoscopic worm extraction via ERCP, often with sphincterotomy for successful removal from the biliary tree 1.
  • Adjunctive therapy: Anthelminthic medications (specific drugs and doses not detailed in the abstract) to eradicate intestinal infestation and prevent recurrence 1.
  • Pancreatic involvement: Endoscopic extraction from the pancreas is technically challenging; alternative management strategies may be required 1.

    • Special Populations

  • No specific guidance provided for pregnancy, pediatrics, elderly, or comorbidities in the given abstracts 1.

    • Key Recommendations

  • Perform endoscopic worm extraction via ERCP for biliary ascariasis to manage cholangitis and pancreatitis effectively (Evidence: Strong 1).
  • Administer anthelminthic therapy to eradicate intestinal Ascaris lumbricoides infestation and prevent recurrence (Evidence: Moderate 1).
  • Consider alternative management strategies for cases where endoscopic extraction from the pancreas is not feasible (Evidence: Expert opinion 1).

    • References

    1 Leung JW, Chung SC. Endoscopic management of biliary ascariasis. Gastrointestinal endoscopy 1988. link71364-4)

    Original source

    1. [1]
      Endoscopic management of biliary ascariasis. — Leung JW, Chung SC Gastrointestinal endoscopy (1988)
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