AI Summary & Key Takeaways
AI InsightConclusions: Based on our experience, ultrasound diagnosis is advocated as a highly sensitive and noninvasive technique for suspected gallbladder ascariasis and it can be repeated frequently to monitor movement of worms in the gallbladder and common bile ducts.
📌 3 Key Takeaways
Abstract
Background/aims: Gallbladder ascariasis is rarely encountered. The causative agent is Ascaris lumbricoides. Presence of ascaris inside the gallbladder can incite acalculous cholecystitis. We aimed in this report to study gallbladder ascariasis. Methods: This is a case study of 28 patients with a diagnosis of gallbladder ascariasis from 2005 to 2010 who were seen in the Department of General Surgery, SMHS Hospital. Results: Three patients with gallbladder ascariasis had associated worms in the common bile duct. On abdominal sonography, all patients showed worms as linear echogenic shadows or the worms showed “belly dance” of worms when actively moving. Acute acalculous cholecystitis was present in 21 patients, and 7 had biliary colic. Dead worms in the gallbladder were seen in 4 patients, of which, one was fragmented and another had calcified form of parasite. Twenty-two patients had spontaneous exit of worms from the gallbladder with a time interval ranging from 1 hour to 144 hours from the time of a diagnosis. Six patients had cholecystectomy. Two patients were subjected to emergency cholecystectomy due to multiple impacted worms not exiting from the gallbladder after conservative treatment. Conclusions: Based on our experience, ultrasound diagnosis is advocated as a highly sensitive and noninvasive technique for suspected gallbladder ascariasis and it can be repeated frequently to monitor movement of worms in the gallbladder and common bile ducts.
Özet
Amaç: Safra kesesi ascariazisi nadir karşılaşılan bir durumdur. Nedeni Ascaris lumbricoides’tir. Safra kesesinde ascarisin bulunması akalküloz kolesistite neden olabilir. Bu çalışma safra kesesi ascariazisini incelemek üzere yapılmıştır. Yöntem: Bu çalışmada 2005 – 2010 yılları arasında SMHS Hastanesi genel cerrahi kliniğinde tespit edilen 28 safra kesesi ascariazisi tanılı vaka incelenmiştir. Sonuçlar: Safra kesesi ascariazisi olan 3 hastada beraberinde koledokta da ascariazis tespit edildi. Abdomen ultrasonografisinde, tüm hastalarda parazitler lineer ekojenik gölgeler şeklinde veya hareket ettiklerinde “göbek dansı” bulgusu ile tespit edildi. 21 hastada akut akalküloz kolesistit ve 7 hastada biliyer kolik mevcuttu. Dört hastada safra kesesinde ölü parazitler tespit edildi ve bunlardan bir tanesi fragmante ve diğeri kalsifiye tipteydi. Yirmi iki hastada tanıdan itibaren 1 – 144 saatlik bir süre zarfında parazitlerin safra kesesinden spontan olarak ayrıldıkları görüldü. Altı hastaya kolesistektomi yapıldı. İki hastaya ise konservatif tedavi altında kese boynuna impakte olan parazitlerin keseden çıkamaması nedeni ile acil kolesistektomi yapıldı. Sonuç: Safra kesesi ascariazisinden şüphe edilen vakalarda ultrasonografi duyarlı ve invaziv olmayan bir yöntemdir ve parazitlerin safra yollarına geçişinin takip edilmesi için sıklıkla kullanılabilir.