At t FIG. I. Intravenous cholangiogram, 40 minute roent- genogram, ascaris (black arrows) in a dilated com- mon bile duct (white arrow). There is also a worm (arrowhead) in the right hepatic duct. S Professor and Chairman, Department of Radiology, Groote Schuur and Red Cross Children’s Hospitals, Cape Town, South Africa. t Senior Specialist, Red Cross Children’s Hospital, Cape Town, South Africa. FEBRUARY, 1976 352 BILIARY ASCARIASIS IN CHILDREN By B. J. CREMIN F.R.A.C.R., F.R.C.R.,* and R. M. FISHER, M.B., CH.B., D.M.D.R.t CAPE TOWN, SOUTH AFRICA ABSTRACT: The ascaris is a common human parasite and has a world wide distribution. In areas where it is endemic, biliary complications are common. In our locality it occurs mainly in children, presenting with upper abdominal colicky pain usually without jaundice. We have analyzed the positive roentgenological findings of 67 cases which presented in one year. The findings on cholangiography are diagnostic. The worm is seen as a linear translucent filling defect in a dilated common bile duct. Usually it is only faintly outlined by thin tram lines and occasionally there may not be excretion of the contrast material. The attention of radiologists is brought to this condition and the appearances of ascariasis infestation of the intestines are also noted. T HE giant round worm (Ascaris lumbri- coides) thrives in a moist warm climate. It is particularly prevalent in Africa and the Far East 5,7,10,11,17 and is endemic unless efficient closed sewerage systems are uti- lized. In Africa it has been conservatively estimated that 6o million people harbor the parasite.5 The definitive hosts are man and the pig, and in man the adult ascarids mainly inhabit the small intestine.5’13 Their reproduction rate is formidable and the gravid female may lay up to 200,000 ova per day.’ The hardy ova can remain viable for many years, so that children are par- ticularly liable to repeated infection from contaminated vegetables, water, and soil. In Africa, massive ascariasis in children is a common form of intestinal obstruc- tion.5’10” The peak incidence of infestation is between four and eight years and at the Red Cross Children’s Hospital, Cape Town, Louw,” in 974, reported that during the period 1958 through 1974, 528 cases of acute abdominal conditions were caused or complicated by ascariasis. They consti- tuted 10-I 5 percent of all acute abdominal emergencies and were second in frequency only to acute appendicitis. The breakdown of complications in these 528 cases was 351 cases (66 percent) of intestinal obstruction, 148 (25 percent) biliary lesions, 25 cases ( five percent) of pancreatitis, two cases (o. percent) of acute appendicitis, and two cases (0.5 percent) of primary peritonitis. Downloaded from www.ajronline.org by 2402:800:62f0:7703:ed25:bb89:cb90:4629 on 07/19/23 from IP address 2402:800:62f0:7703:ed25:bb89:cb90:4629. Copyright ARRS. For personal use only; all rights reserved
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Related Documents
