Intrahepatic ascariasis – Common parasite at an uncommon site

Biliary infections and biliary cholangitis are common terms used to define infections of the biliary tree. Bacteria are the most common cause for these infections. Parasites can form an important group of biliary infections and act as causative agents or may predispose bacterial infections. Despite being an important cause, these infections are quite uncommon to find, especially in the intrahepatic biliary system[1]. Ascariasis is a common infection in the tropical and subtropical countries[2]. Intrahepatic extension of this parasite through the extrahepatic biliary system is uncommon. Ascariasis is generally diagnosed on basis of faecal examination. However, diagnosing intrahepatic ascariasis is challenging. Fortunately, ultrasonography plays a pivotal role in recognising this infection[3]. Imaging recognition of intrahepatic biliary ascariasis is an important issue in order to achieve immediate diagnosis and provide urgent treatment to avoid fatal complications.