|
|
| Year : 2017 | Volume
: 23
| Issue : 5 | Page : 306 |
|
| Ascariasis and pancreatitis |
|
|
Vipul D Yagnik
Department of Surgical Gastroenterology, Consultant Endoscopic and Laparoscopic Surgeon, Ronak Endo-laparoscopy and General Surgical Hospital, Patan, Gujarat, India
Click here for correspondence address and email
| Date of Web Publication | 18-Sep-2017 |
|
|
 |
|
How to cite this article:
Yagnik VD. Ascariasis and pancreatitis. Saudi J Gastroenterol 2017;23:306 |
Sir,
I read with great interest an article entitled, “A rare etiology of idiopathic acute pancreatitis” by Sharma et al.[1] It is an interesting and unusual case. I would like to congratulate the authors for their excellent effort. However, I have a few observations in this connection.
The authors of the report mention that ultrasonography (USG) has low sensitivity for pancreatic duct ascariasis. I would like to state that USG is a simple, quick, safe, noninvasive, and highly accurate test reflecting the ascariasis morphology, which may be single or multiple, long, linear echogenic strips without acoustic shadowing in the biliary or pancreatic ducts (strip sign).[2]
In this case, magnetic resonance cholangiopancreatography (MRCP) was normal. Studies have shown that MRCP and endo-sonography are comparable in the presence of nondilated common bile duct.[3] The failure to diagnose on USG and MRCP in the index case may be due to the migration of the worm, which may move freely in and out of the bile or pancreatic duct. In most patients worms move out of the duct within 24 hours of inducing symptoms. Real-time USG also monitors the exit of the worm through the biliary tree or pancreatic duct. Worm in the duodenum is hard to diagnose by USG. A review of 300 patients showed that ultrasound and clinical findings are the mainstays of diagnosing pancreatitis secondary to ascariasis.[4]
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
 References | |  |
| 1. | Sharma M, Somani P. A rare etiology of idiopathic acute pancreatitis. Saudi J Gastroenterol 2017;23:209-10.  [ PUBMED] [Full text] |
| 2. | Ferreyra NP, Cerri GG. Ascariasis of the alimentary tract, liver, pancreas and biliary system: Its diagnosis by ultrasonography. Hepatogastroenterology 1998;45:932-7. [ PUBMED] |
| 3. | Kondo S, Isayama H, Akahane M, Toda N, Sasahira N, Nakai Y, et al. Detection of common bile duct stones: Comparison between endoscopic ultrasonography, magnetic resonance cholangiography, and helical-computed tomographic cholangiography. Eur J Radiol 2005;54:271-5. [ PUBMED] |
| 4. | Sandouk F, Haffar S, Zada M, Graham DY, Anand BS. Pancreatic-biliary ascariasis: Experience of 300 cases. Am J Gastroenterol 1997;92:2264-7. |
Correspondence Address:
Vipul D Yagnik
77, Siddhraj Nagar, Rajmahal Road, Patan, Gujarat
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/sjg.SJG_301_17
|
|
| This article has been cited by | | 1 |
Human Ascariasis: An Updated Review |
|
| Alexander K.C. Leung, Amy A.M. Leung, Alex H.C. Wong, Kam L. Hon | | Recent Patents on Inflammation & Allergy Drug Discovery. 2021; 14(2): 133 | | [Pubmed] | [DOI] | |
|
|
|
|
|
|
|
|
