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Gastrointestinal
Diagnosis
Biliary System
Infection
Pancreatobiliary Parasites
Pancreatobiliary Parasites
Siva P. Raman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Synonyms

          • Biliary ascariasis, biliary clonorchiasis, biliary fascioliasis, biliary echinococcosis

        • Definitions

          • Biliary and pancreatic duct (PD) involvement by parasitic infections (e.g., ascariasis, clonorchiasis, echinococcosis, fascioliasis)

        IMAGING

        • General Features

          • CT Findings

            • MR Findings

              • Ultrasonographic Findings

                • Radiographic Findings

                  • Nonvascular Interventions

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Anzali BC et al: Ascariasis in common bile duct resulting in a subhepatic abscess. Acta Gastroenterol Belg. 83(3):488-90, 2020
                                            2. Ekpanyapong S et al: Fungal and parasitic infections of the liver. Gastroenterol Clin North Am. 49(2):379-410, 2020
                                            3. Liao G et al: Clonorchiasis in patients with biliary and pancreatic diseases: diagnosis and risk factors. Biomed Res Int. 2020:2946541, 2020
                                            4. Reddy KR: Infections of the liver and biliary system. Gastroenterol Clin North Am. 49(2):xv-vi, 2020
                                            5. Villa-Gómez Roig G et al: Spectrum of biliary parasites affecting the biliary tree (Fasciola hepatica, Echinococcus granulosus, and Ascaris lumbricoides). Endoscopy. 50(8):E224-6, 2018
                                            6. Khuroo MS et al: Hepatobiliary and pancreatic ascariasis. World J Gastroenterol. 22(33):7507-17, 2016
                                            7. Das AK: Hepatic and biliary ascariasis. J Glob Infect Dis. 6(2):65-72, 2014
                                            8. Dusak A et al: Radiological imaging features of fasciola hepatica Infection - a pictorial review. J Clin Imaging Sci. 2:2, 2012
                                            9. Goel A et al: Biliary ascariasis: mimicker of retained bile duct stone. Dig Endosc. 24(6):480, 2012
                                            10. Nunnari G et al: Hepatic echinococcosis: clinical and therapeutic aspects. World J Gastroenterol. 18(13):1448-58, 2012
                                            11. Ding ZX et al: 3 T MR cholangiopancreatography appearances of biliary ascariasis. Clin Radiol. 66(3):275-7, 2011
                                            12. Lim JH: Liver flukes: the malady neglected. Korean J Radiol. 12(3):269-79, 2011
                                            13. Sharma M: Echogenic shadow in the common bile duct. Diagnosis: biliary ascariasis. Gastroenterology. 141(1):e14-5, 2011
                                            14. Khoshbaten M et al: Endoscopic retrograde cholangiography for intrabiliary rupture of hydatid cyst. Dig Endosc. 21(4):277-9, 2009
                                            15. Wu S: Sonographic findings of ascaris lumbricoides in the gastrointestinal and biliary tracts. Ultrasound Q. 25(4):207-9, 2009
                                            16. Khandelwal N et al: Biliary parasites: diagnostic and therapeutic strategies. Curr Treat Options Gastroenterol. 11(2):85-95, 2008
                                            17. Lim JH et al: Biliary parasitic diseases including clonorchiasis, opisthorchiasis and fascioliasis. Abdom Imaging. 33(2):157-65, 2008
                                            18. Lim JH: Parasitic diseases in the abdomen: imaging findings. Abdom Imaging. 33(2):130-2, 2008
                                            19. Marcos LA et al: Update on hepatobiliary flukes: fascioliasis, opisthorchiasis and clonorchiasis. Curr Opin Infect Dis. 21(5):523-30, 2008
                                            20. Al Absi M et al: Biliary ascariasis: the value of ultrasound in the diagnosis and management. Ann Saudi Med. 27(3):161-5, 2007
                                            21. Lim JH et al: Parasitic diseases of the biliary tract. AJR Am J Roentgenol. 188(6):1596-603, 2007
                                            22. Rana SS et al: Parasitic infestations of the biliary tract. Curr Gastroenterol Rep. 9(2):156-64, 2007
                                            23. Arya PK et al: Magnetic resonace appearance of gall bladder ascariasis. Indian J Med Sci. 59(5):208-10, 2005
                                            24. Rim HJ: Clonorchiasis: an update. J Helminthol. 79(3):269-81, 2005
                                            25. Choi BI et al: Clonorchiasis and cholangiocarcinoma: etiologic relationship and imaging diagnosis. Clin Microbiol Rev. 17(3):540-52, table of contents, 2004
                                            26. Koumanidou C et al: Sonographic features of intestinal and biliary ascariasis in childhood: case report and review of the literature. Ann Trop Paediatr. 24(4):329-35, 2004
                                            27. Haseeb AN et al: Evaluation of excretory/secretory Fasciola (Fhes) antigen in diagnosis of human fascioliasis. J Egypt Soc Parasitol. 33(1):123-38, 2003
                                            28. Amjad N et al: An unusual presentation of acute cholecystitis: biliary ascariasis. Hosp Med. 62(6):370-1, 2001
                                            29. Pedrosa I et al: Hydatid disease: radiologic and pathologic features and complications. Radiographics. 20(3):795-817, 2000
                                            30. Capallo DV et al: Biliary ascariasis. South Med J. 77(9):1201-2, 1984
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Biliary ascariasis, biliary clonorchiasis, biliary fascioliasis, biliary echinococcosis

                                                  • Definitions

                                                    • Biliary and pancreatic duct (PD) involvement by parasitic infections (e.g., ascariasis, clonorchiasis, echinococcosis, fascioliasis)

                                                  IMAGING

                                                  • General Features

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Radiographic Findings

                                                            • Nonvascular Interventions

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Anzali BC et al: Ascariasis in common bile duct resulting in a subhepatic abscess. Acta Gastroenterol Belg. 83(3):488-90, 2020
                                                                                      2. Ekpanyapong S et al: Fungal and parasitic infections of the liver. Gastroenterol Clin North Am. 49(2):379-410, 2020
                                                                                      3. Liao G et al: Clonorchiasis in patients with biliary and pancreatic diseases: diagnosis and risk factors. Biomed Res Int. 2020:2946541, 2020
                                                                                      4. Reddy KR: Infections of the liver and biliary system. Gastroenterol Clin North Am. 49(2):xv-vi, 2020
                                                                                      5. Villa-Gómez Roig G et al: Spectrum of biliary parasites affecting the biliary tree (Fasciola hepatica, Echinococcus granulosus, and Ascaris lumbricoides). Endoscopy. 50(8):E224-6, 2018
                                                                                      6. Khuroo MS et al: Hepatobiliary and pancreatic ascariasis. World J Gastroenterol. 22(33):7507-17, 2016
                                                                                      7. Das AK: Hepatic and biliary ascariasis. J Glob Infect Dis. 6(2):65-72, 2014
                                                                                      8. Dusak A et al: Radiological imaging features of fasciola hepatica Infection - a pictorial review. J Clin Imaging Sci. 2:2, 2012
                                                                                      9. Goel A et al: Biliary ascariasis: mimicker of retained bile duct stone. Dig Endosc. 24(6):480, 2012
                                                                                      10. Nunnari G et al: Hepatic echinococcosis: clinical and therapeutic aspects. World J Gastroenterol. 18(13):1448-58, 2012
                                                                                      11. Ding ZX et al: 3 T MR cholangiopancreatography appearances of biliary ascariasis. Clin Radiol. 66(3):275-7, 2011
                                                                                      12. Lim JH: Liver flukes: the malady neglected. Korean J Radiol. 12(3):269-79, 2011
                                                                                      13. Sharma M: Echogenic shadow in the common bile duct. Diagnosis: biliary ascariasis. Gastroenterology. 141(1):e14-5, 2011
                                                                                      14. Khoshbaten M et al: Endoscopic retrograde cholangiography for intrabiliary rupture of hydatid cyst. Dig Endosc. 21(4):277-9, 2009
                                                                                      15. Wu S: Sonographic findings of ascaris lumbricoides in the gastrointestinal and biliary tracts. Ultrasound Q. 25(4):207-9, 2009
                                                                                      16. Khandelwal N et al: Biliary parasites: diagnostic and therapeutic strategies. Curr Treat Options Gastroenterol. 11(2):85-95, 2008
                                                                                      17. Lim JH et al: Biliary parasitic diseases including clonorchiasis, opisthorchiasis and fascioliasis. Abdom Imaging. 33(2):157-65, 2008
                                                                                      18. Lim JH: Parasitic diseases in the abdomen: imaging findings. Abdom Imaging. 33(2):130-2, 2008
                                                                                      19. Marcos LA et al: Update on hepatobiliary flukes: fascioliasis, opisthorchiasis and clonorchiasis. Curr Opin Infect Dis. 21(5):523-30, 2008
                                                                                      20. Al Absi M et al: Biliary ascariasis: the value of ultrasound in the diagnosis and management. Ann Saudi Med. 27(3):161-5, 2007
                                                                                      21. Lim JH et al: Parasitic diseases of the biliary tract. AJR Am J Roentgenol. 188(6):1596-603, 2007
                                                                                      22. Rana SS et al: Parasitic infestations of the biliary tract. Curr Gastroenterol Rep. 9(2):156-64, 2007
                                                                                      23. Arya PK et al: Magnetic resonace appearance of gall bladder ascariasis. Indian J Med Sci. 59(5):208-10, 2005
                                                                                      24. Rim HJ: Clonorchiasis: an update. J Helminthol. 79(3):269-81, 2005
                                                                                      25. Choi BI et al: Clonorchiasis and cholangiocarcinoma: etiologic relationship and imaging diagnosis. Clin Microbiol Rev. 17(3):540-52, table of contents, 2004
                                                                                      26. Koumanidou C et al: Sonographic features of intestinal and biliary ascariasis in childhood: case report and review of the literature. Ann Trop Paediatr. 24(4):329-35, 2004
                                                                                      27. Haseeb AN et al: Evaluation of excretory/secretory Fasciola (Fhes) antigen in diagnosis of human fascioliasis. J Egypt Soc Parasitol. 33(1):123-38, 2003
                                                                                      28. Amjad N et al: An unusual presentation of acute cholecystitis: biliary ascariasis. Hosp Med. 62(6):370-1, 2001
                                                                                      29. Pedrosa I et al: Hydatid disease: radiologic and pathologic features and complications. Radiographics. 20(3):795-817, 2000
                                                                                      30. Capallo DV et al: Biliary ascariasis. South Med J. 77(9):1201-2, 1984