Ascariasis in the Wirsung duct favored by pregnancy

Abstract

Introduction: Ascaris lumbricoides is a helminth associated with poor sanitary conditions, endemic in populations in peri-urban, rural and jungle areas. Biliary ascariasis is rarely reported and particularly its presence in the Wirsung duct is strange. Objectives: report the case of a patient with ascariasis in the Wirsung duct. Materials and methods: case study of a 17-year-old pregnant patient with epigastric pain, vomiting and fever. Results: an abdominal ultrasound showed hepatomegaly versus an inflammatory process, biliary ascariasis and bilateral renal lithiasis, therefore, he received anthelmintic treatment with albendazole 200 mg daily for five days and in paraclinical studies an elevation of lipase three times above its value was evident. normal. Because he did not improve, a study was performed with endoscopic retrograde cholangiopancreatography (ERCP), revealing an obstructive jaundice syndrome secondary to erratic migration of Ascaris lumbricoides, complicated with suppurative cholangitis, also acute pancreatitis due to Ascaris lumbricoides, in the process, six adults were withdrawn. bile duct females and an adult Wirsung duct female. After ERCP, antibiotic therapy and anthelmintic are continued, followed by a control ultrasound, which shows a satisfactory evolution, so a medical discharge is decided. Conclusion: in pregnant patients and with an epidemiological history, it is important to study and treat possible intestinal parasitosis, to avoid erratic migrations of helminths.