Parasitosis in the bile duct, report of 3 cases and literature review

Abstract Background Roundworm has a worldwide incidence of 25% of the population and biliary ascariasis accounts for 10–17% of all cases of roundworm infestation, predominantly in developing countries in tropical and subtropical climates. In the bile duct, it causes pyogenic cholangitis (stenosis and pigmented stones), cholecystitis, pancreatitis and liver abscesses. Clinical cases We present the cases of three patients who showed symptoms of biliary disease. Only one of the three cases had imaging data (ultrasound) compatible with biliary ascariasis. However the other two cases had biliary disease mimicking cholecystitis and cholangitis and diagnosis was confirmed at the time of surgical exploration. Conclusions The management of biliary ascariasis rests on three main pillars according to severity. It starts with medical management, followed by endoscopic if the conservative option fails, and finally surgical management in selected cases, with a favourable prognosis in the majority of patients.