Bile duct « ThePclinic

Unusual Presentations of Intestinal Worms

: Ascaria

Round worm, hook worm, tape worm, thread worm and whipworms are some of the common helminthes affecting human. These are transmitted through feco-oral route in the areas of poor sanitation. Common manifestations of the diseases caused by these groups of parasites include: pain abdomen, anemia, vomiting and poor health. Apart from these, some unusual complications from infestation of these worms are also seen.

Round worm (Ascariasis): These may lodge in the common bile duct, pancreatic duct and liver apart from their natural habitat; small intestine. That may cause obstruction to the free flow of bile resulting in obstructive jaundice, pancreatitis and liver abscess respectively. That may affect the liver function and cause inflammation of bile channel called cholangitis. Ascaria larva during the course of its development passes through the respiratory tract to come over to the alimentary tract once again, which causes night hawking cough and sometimes lungs infection by secondary bacterial invasion. A lot of adult round worms living or dead after administration of drugs or as such may cause obstruction of the alimentary tract which may arouse an emergency situation. These may become irritated during surgery by anesthetics and come up, to be aspirated to the respiratory tract causing the dangerous collapse of lungs.

Hook worm larva enters the body through the bare skin of foot, to find its way to the blood or lymphatic to reach the alimentary tract via respiratory tract. At the site of entry may evoke inflammation and intense pruritus called “Ground itch”. The route of its migration can be seen as an inflamed streak over the skin called the “Larva migrans”, which evokes pruritus. Finally they lodge themselves in the upper part of small intestine to cause the classical symptoms of the ankylostomiasis.

Thread worm egg are laid near the anal canal, hatch there and larva may migrate to the vagina in female to cause pruritus there. It may ascend upwards to the fallopian tubes, and even to the peritoneum to cause an infection there. Sometimes these may enter the appendix to cause appendicitis. These find their way again to the alimentary tract being carried by the nail to the mouth during intake of food.

Filed under: Digestive Disorders,General,community — Tags: Bile duct, Jaundice, Small intestine — Dr.Prahallad @ December 5, 2009 6:17 pm

Pain Upper Mid-Abdomen-2

: Opened Gall Bladder with Gal Stones

The tags attached to the disease are fat,fertile,fifty and female are not absolute.It is said for gall stone disease.This disease gives rise to pain in the upper mid-abdomen.Other tags attached to it are flatulent dyspepsia .Some other diseases may be associated with it namely a hiatus hernia , diverticulosis of colon or pancreatitis.

Typically pain comes after a fatty meal.Other symptoms are vomiting ,loss of appetite,jaundice and fever .If associated with other diseases their symptoms also manifest.Gall stones form in a diseased gall bladder,supersaturated bile and infected biliary system .It is prevalent in a areas prone for malaria and haemolytic diseases such as sickle cell disease.It is said that “Every gall tone is a tomb stone erected to the memory of bacteria living or dead within it”.

The stones are of a few types namely a cholesterol stone,a pigment stone or a mixed stone.The inflammation of gall bladder is called cholecystitis.It may occur with a gall stone when it is called a cholelithiasis with cholecystitis . when cholecystitis occurs without a gall stone is called an acalculus chilecystitis.Complications do follow a long standing cholecystitis.They are gangrene of gall bladder,pancreatitis,perforation of gall bladder,stone migration to common bile duct and it’s obstruction, stone obstruction of intestine and pus in gall bladder to name few.It may become associated with a cancer of gall bladder also.