Biliary Ascariasis: An Unusual Cause of Biliary Colic

Introduction: Ascariasis by Ascaris lumbricoides is a cosmopolitan disease. Biliary ascariasis is unusual in our country. We report a case of biliary ascariasis revealed by biliary colic. Observation: A 22-year-old woman with no particular history was received for biliary colic associated to vomiting without fever or bowel disorders. On examination, there were pain and defense at the right upper quadrant and a Murphy sign. Moreover, the clinical examination was normal. Blood cells count, renal function, liver function, coagulation and blood ionogram were normal. The abdominopelvic ultrasonography showed a probable parasitosis of the bile duct with gallbladder sludge and dilatation of the common bile duct. The abdominopelvic CT scan revealed intrahepatic and common bile duct (CBD) dilatation and organic image in the common bile duct. Right subcostal laparotomy was allowed to extract an ascaris blocking the common bile duct. A cholecystectomy and drainage of the bile duct with a Kehr drain were performed. The postoperative course was marked by wound surgical suppurative resolved by treatment. She was discharged on the 9th post-operative day. T-tube was removed on the 21st post-operative day after normal cholangiography. Conclusion: Biliary ascariasis is rare in our regions. The diagnosis must be kept in mind in case of biliary colic and ultrasound confirm the diagnosis. Surgical treatment gives good results in our regions.