Biliary ascariasis.

Ascariasis is a common helminthic infestation in Malaysia. Ascaris lumbricoides normally lives in the upper small bowel without causing symptoms. Complications arise when these worms migrate into the bile duct (biliary ascariasis) causing biliary colic, cholangitis, acalculous cholecystitis and hepatic abscess l . A case of biliary ascariasis presenting as biliary colic is described. Diagnosis was established at Endoscopic Retrograde Cholangio-Pancreatography (ERCP). Endoscopic removal of the worm led to rapid resolution of symptoms.