{"title":"Diagnosis and treatment of Ascarial pancreatitis: a case report and literature review.","authors":"Hongyu He, Hao Guo, Zhongtao Li, Shu Wang, GuoJun Zhou, Zhi Liu, Jianyu Chen, Zhengwei Leng, Liang Xie","doi":"10.1093/omcr/omaf135","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The prevalence of diseases caused by parasites has decreased due to improved sanitary conditions. Acute pancreatitis caused by parasites, especially Ascaris lumbricoides worms, is relatively rare and difficult to diagnose. In some cases, it may even be misdiagnosed as idiopathic acute pancreatitis due to the difficulty of identifying the underlying cause. Research indicates that about 1.4 billion people worldwide are infected with Ascaris lumbricoides worms, and pancreatitis caused by roundworms accounts for only 5.50% of the total cases. Therefore, it is imperative to gain a comprehensive understanding of the pathological process, diagnosis, and treatment of pancreatitis caused by Ascaris lumbricoides worms.</p><p><strong>Case presentation: </strong>We describe a case of Ascariasis-induced pancreatitis in an 82-year-old woman who was admitted to our emergency department with persistent abdominal pain, nausea, and vomiting for 6 h. Abdominal magnetic resonance imaging and magnetic resonance cholangiopancreatography revealed abnormal tubular signals in the common bile duct segment, accompanied by dilation of the hilar and common bile ducts. Consequently, a diagnosis of Ascariasis-induced pancreatitis was made.</p><p><strong>Result: </strong>Ascariasis-induced pancreatitis was detected in individuals of all age groups and genders. Most cases occurred in Asia (43 cases, 66.15%) and Europe (8 cases, 12.3%). The most common symptoms were abdominal pain and fever. The diagnosis was primarily by ultrasound examination (43.3%) and endoscopic procedures. Regarding treatment, 76.7% of the patients received antiparasitic drugs, while 85.45% underwent endoscopic procedures to directly remove the Ascaris worms. In our case, the patient underwent laparoscopic procedures to remove a 20 cm-long ascaris worms and alleviate symptoms.</p><p><strong>Conclusion: </strong>Ascariasis-induced pancreatitis is more commonly detected among Asians, being more frequent with adult females. The clinical symptoms are often atypical compared to those of pancreatitis caused by other etiologies. In cases of acute pancreatitis resulting from biliary ascariasis, it is recommended that clinicians employ a combination of imaging modalities to support the diagnostic process. The literature indicates that endoscopic retrograde cholangiopancreatography (ERCP) has been the primary treatment approach in the majority of reported cases. In recent years, laparoscopic surgery has been found to be associated with faster recovery and reduced trauma. In complex cases involving severe cholecystitis or intrahepatic biliary ascariasis, laparoscopy offers distinct and irreplaceable benefits.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 8","pages":"omaf135"},"PeriodicalIF":0.4000,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12365966/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oxford Medical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/omcr/omaf135","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The prevalence of diseases caused by parasites has decreased due to improved sanitary conditions. Acute pancreatitis caused by parasites, especially Ascaris lumbricoides worms, is relatively rare and difficult to diagnose. In some cases, it may even be misdiagnosed as idiopathic acute pancreatitis due to the difficulty of identifying the underlying cause. Research indicates that about 1.4 billion people worldwide are infected with Ascaris lumbricoides worms, and pancreatitis caused by roundworms accounts for only 5.50% of the total cases. Therefore, it is imperative to gain a comprehensive understanding of the pathological process, diagnosis, and treatment of pancreatitis caused by Ascaris lumbricoides worms.
Case presentation: We describe a case of Ascariasis-induced pancreatitis in an 82-year-old woman who was admitted to our emergency department with persistent abdominal pain, nausea, and vomiting for 6 h. Abdominal magnetic resonance imaging and magnetic resonance cholangiopancreatography revealed abnormal tubular signals in the common bile duct segment, accompanied by dilation of the hilar and common bile ducts. Consequently, a diagnosis of Ascariasis-induced pancreatitis was made.
Result: Ascariasis-induced pancreatitis was detected in individuals of all age groups and genders. Most cases occurred in Asia (43 cases, 66.15%) and Europe (8 cases, 12.3%). The most common symptoms were abdominal pain and fever. The diagnosis was primarily by ultrasound examination (43.3%) and endoscopic procedures. Regarding treatment, 76.7% of the patients received antiparasitic drugs, while 85.45% underwent endoscopic procedures to directly remove the Ascaris worms. In our case, the patient underwent laparoscopic procedures to remove a 20 cm-long ascaris worms and alleviate symptoms.
Conclusion: Ascariasis-induced pancreatitis is more commonly detected among Asians, being more frequent with adult females. The clinical symptoms are often atypical compared to those of pancreatitis caused by other etiologies. In cases of acute pancreatitis resulting from biliary ascariasis, it is recommended that clinicians employ a combination of imaging modalities to support the diagnostic process. The literature indicates that endoscopic retrograde cholangiopancreatography (ERCP) has been the primary treatment approach in the majority of reported cases. In recent years, laparoscopic surgery has been found to be associated with faster recovery and reduced trauma. In complex cases involving severe cholecystitis or intrahepatic biliary ascariasis, laparoscopy offers distinct and irreplaceable benefits.
期刊介绍:
Oxford Medical Case Reports (OMCR) is an open access, peer-reviewed online journal publishing original and educationally valuable case reports that expand the field of medicine. The journal covers all medical specialities including cardiology, rheumatology, nephrology, oncology, neurology, and reproduction, comprising a comprehensive resource for physicians in all fields and at all stages of training. Oxford Medical Case Reports deposits all articles in PubMed Central (PMC). Physicians and researchers can find your work through PubMed , helping you reach the widest possible audience. The journal is also indexed in the Web of Science Core Collection . Oxford Medical Case Reports publishes case reports under the following categories: Allergy Audiovestibular medicine Cardiology and cardiovascular systems Critical care medicine Dermatology Emergency medicine Endocrinology and metabolism Gastroenterology and hepatology Geriatrics and gerontology Haematology Immunology Infectious diseases and tropical medicine Medical disorders in pregnancy Medical ophthalmology Nephrology Neurology Oncology Paediatrics Pain Palliative medicine Pharmacology and pharmacy Psychiatry Radiology, nuclear medicine, and medical imaging Respiratory disorders Rheumatology Sexual and reproductive health Sports Medicine Substance abuse.