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35.Clinical Profile of Hepatobiliary and Pancreatic Ascariasis

Dilaram Khan1, Mohammad Iltaf2 and Fakhare Alam2

ABSTRACT

Objective: To determine the clinical presentations of patients with hepatobiliary ascariasis

Study Design: Case series study

Place and Duration of Study: This study was conducted at the Department of Gastroenterology, Lady Reading Hospital, Peshawar from 1st October 2019 to 30th June 2020.

Materials and Methods: Eighteen patients of either gender, greater than 12 years of age and having ultrasonic evidence of hepatobiliary or pancreatic ascariasis were enrolled. Patients with hemodynamic instability or those who decline endoscopic retrograde cholangiopancreatography were excluded from this study. All patients were admitted to the ward. Necessary baseline investigations were carried out. Patients were treated symptomatically and endoscopic retrograde cholangiopancreatography was performed after taking consent. Worms were removed using snare and/or balloon.

Results: There were 6 (33.33%) males and 12 (66.66%) females. Majority of patients were between 21 to 30 years with mean age of 27.83±12.00 years. Epigastric pain was the most frequently occurring symptom present in all 18 (100%) patients, followed by vomiting in 12 (66.66%) patients. Obstructive jaundice was present in 10 (55.55%), anemia in 9(50%) patients, cholangitis in 6 (33.33%) patients and acute pancreatitis in 3 (16.66%) patients. Twelve (66.66%) patients were having single worms, 4 (22.22%) patients were two worms, 2 (11.11%) patients were multiple worms and maximum number of worms extracted was 10. Worms protruding from major papilla were seen in 9(50%), worms protruding from both major and minor papillae were seen in 1 (5.55%), seen fluoroscopically in 8 (44.44%) patients.

Conclusion: Hepatobiliary worms have not remained an uncommon entity in certain districts of KPK, affecting mainly young females, presenting with epigastric pain, vomiting and jaundices.

Key Words: Ascariasis, Jaundice, Epigastric pain, Endoscopic retrograde cholangiopancreatography (ECRP)

Citation of article: Khan D, Iltaf M, Alam F. Clinical Profile of Hepatobiliary and Pancreatic Ascariasis. Med Forum 2022;33(2):155-157.