Ascariasis presenting as acute cholangitis due to common bile duct stone

Ascaris lumbricoides is an intestinal parasite, more common habitant of the small intestine, particularly in the jejunum. It can produce a variety of presentations starting from anemia, gastrointestinal bleeding, intestinal obstruction, perforations, intussusception, and rarely obstructive jaundice. Obstructive jaundice is mainly due to proximal migration of the parasite into the biliary tree and causing an obstruction. It is the most common following biliary procedure. Here, we report the case of obstructive jaundice and cholangitis due to biliary ascariasis in a patient without any prior biliary procedure. Prompt intervention is needed in those cases of ascariasis with biliary sepsis. The patient has been managed by emergency cholecystectomy with common bile duct exploration and T-tube insertion.