Acute cholecystitis, obstructive jaundice, pyogenic cholangitis, and acute pancreatitis caused by Ascaris lumbricoides:: Report of a case

A 64-year-old woman presented with right upper abdominal pain, nausea, and vomiting. Physical examination revealed tenderness at palpation of the right upper quadrant. Laboratory results demonstrated elevated liver enzymes, direct bilirubin, serum amylase level, and leukocyte count. Abdominal ultrasonography and computerized tomography showed mobile parasites within the gallbladder and common bile duct. The gall bladder wall was 5 mm in thickness, and the pancreas was edematous. The symptoms of the patient did not subside with medical treatment. She underwent surgery. Cholecystectomy, choledochus exploration, and transduodenal sphincteroplasty were performed. The patient was uneventful in the postoperative period and discharged 8 days after surgery.