Diagnosis and treatment of Ascarial pancreatitis: a case report and literature review.

IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL
Oxford Medical Case Reports Pub Date : 2025-08-20 eCollection Date: 2025-08-01 DOI:10.1093/omcr/omaf135
Hongyu He, Hao Guo, Zhongtao Li, Shu Wang, GuoJun Zhou, Zhi Liu, Jianyu Chen, Zhengwei Leng, Liang Xie
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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.

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蛔虫性胰腺炎的诊断和治疗:1例报告并文献复习。
背景:由于卫生条件的改善,由寄生虫引起的疾病的流行率已经下降。由寄生虫,特别是蛔虫引起的急性胰腺炎相对罕见且难以诊断。在某些情况下,由于难以确定根本原因,它甚至可能被误诊为特发性急性胰腺炎。研究表明,全世界约有14亿人感染了类蛔虫,而蛔虫引起的胰腺炎仅占总病例的5.50%。因此,全面了解蛔虫引起的胰腺炎的病理过程、诊断和治疗是十分必要的。病例介绍:我们报告一例82岁女性蛔虫引起的胰腺炎病例,她因持续腹痛、恶心和呕吐6小时而入院急诊科。腹部磁共振成像和磁共振胆管造影显示胆总管段异常小管信号,并伴有肝门和胆总管扩张。因此,诊断为蛔虫性胰腺炎。结果:在所有年龄组和性别的个体中均检测到蛔虫性胰腺炎。主要发生在亚洲(43例,66.15%)和欧洲(8例,12.3%)。最常见的症状是腹痛和发烧。诊断主要通过超声检查(43.3%)和内窥镜检查。治疗方面,76.7%的患者接受了抗寄生虫药物治疗,85.45%的患者接受了内镜手术直接去除蛔虫。在我们的病例中,患者接受了腹腔镜手术,切除了20厘米长的蛔虫,缓解了症状。结论:蛔虫性胰腺炎在亚洲人群中更为常见,多发于成年女性。与其他病因引起的胰腺炎相比,其临床症状往往不典型。在胆道蛔虫病引起的急性胰腺炎病例中,建议临床医生采用综合成像方式来支持诊断过程。文献表明,内镜逆行胰胆管造影(ERCP)已成为大多数报道病例的主要治疗方法。近年来,腹腔镜手术已被发现与更快的恢复和减少创伤有关。在复杂的情况下,包括严重的胆囊炎或肝内胆道蛔虫病,腹腔镜提供了独特的和不可替代的好处。
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来源期刊
Oxford Medical Case Reports
Oxford Medical Case Reports MEDICINE, GENERAL & INTERNAL-
CiteScore
0.90
自引率
0.00%
发文量
125
审稿时长
19 weeks
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.
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