摘要

Biliary ascariasis is as frequent a cause of adult biliary disease as gallstones in Kashmir Valley, India. In the present study, we prospectively evaluated the role of sonography in the diagnosis of biliary ascariasis and its utility in monitoring the exit of worms from the bile duct. Sonography was performed on 28 patients with biliary ascariasis proven by endoscopic retrograde cholangiopancreatography. The bile ducts were dilated on sonography in 26 patients. The characteristic sonographic features of worms in the bile duct were as follows: (a) a single, long, linear or curved echogenic structure without acoustic shadowing (2 patients); (b) multiple, long, linear, parallel echogenic strips, usually without acoustic shadowing (15 patients); (c) a thick, long, linear or curved, nonshadowing echogenic strip containing a central, longitudinal anechoic tube, probably representing the digestive tract of the worm (7 patients); and (d) characteristic movement of these long echogenic structures within the bile duct (8 patients). One patient with pancreatic ascariasis exhibited long, linear, nonshadowing echogenic strips in a dilated pancreatic duct. Other sonographic changes observed in these patients were (a) gallbladder distention (10 patients), edema of the gallbladder wall (8 patients), sludge within the gallbladder (11 patients), a coiled echogenic structure within the gallbladder (1 patient); (b) multiple liver abscesses (1 patient); and (c) edematous pancreatitis (4 patients). Sonography detected worms in the biliary tree in 24 of 28 patients (85.7%). Serial sonograms accurately demonstrated the spontaneous exit of worms in 18 patients and the persistence of worms in 3 patients. Sonography is a simple, rapid, and noninvasive method for diagnosis and follow-up of patients with biliary ascariasis.

译文

在印度的克什米尔山谷，胆汁性结石病和胆结石一样是成人胆汁疾病的常见原因。在目前的研究中，我们前瞻性地评估了超声检查在胆源性虫病诊断中的作用及其在监测蠕虫从胆管出口中的效用。对 28 例经内镜逆行胰胆管造影证实的胆道虫病患者进行了超声检查。对 26 例患者的胆管扩张进行了超声检查。胆管蠕虫的特征性超声特征如下: (a) 没有声阴影的单一、长、线性或弯曲回声结构 (2 名患者); (b) 多个, 长的，线性的，平行的回声条，通常没有声音阴影 (15 名患者); (c)一种厚的、长的、线性的或弯曲的、无阴影的回声条，包含一个中心的、纵向的消声管，可能代表蠕虫的消化道 (7 名患者); 和 (d) 这些长回声结构在胆管内的特征运动 (8 例患者)。1 例胰虫病患者在扩张的胰管中显示出长的、线性的、无阴影的回声条带。在这些患者中观察到的其他超声变化是 (a) 胆囊扩张 (10 名患者) 、胆囊壁水肿 (8 名患者) 、胆囊内污泥 (11 名患者), 胆囊内的卷曲回声结构 (1 例); (b) 多发性肝脓肿 (1 例); 和 (c)水肿性胰腺炎 (4 例)。超声检查在 28 名患者中的 24 名 (85.7%) 中发现了胆汁树中的蠕虫。连续声像图准确地显示了 18 名患者蠕虫的自发退出和 3 名患者蠕虫的持续存在。超声检查是一种简单、快速、无创的诊断和随访胆道虫病患者的方法。