© 2003 BMJ Publishing Group, British Association for Accident & Emergency Medicine, & Faculty of Accident & Emergency Medicine
CASE REPORT
An unusual cause of cholecystitis: a worm in the bag
1 Infectious Diseases Department, Cumhuriyet University Hospital, Sivas, Turkey
2 General Surgery Department, the Cumhuriyet University Hospital
3 Radiology Department, Cumhuriyet University Hospital
Correspondence to:
Correspondence to:
Dr N Elaldi, Cumhuriyet University Hospital, Infectious Diseases Department, 58140, Sivas, Turkey;
nelaldi@cumhuriyet.edu.tr
Accepted 15 October 2002
Keywords: cholecystitis
| The first 150 words of the full text of this article appear below. |
Ascariasis, a worldwide parasitic disease, is regarded by some authorities as the most common parasitic infection in human.1 The parasites can migrate into the biliary tract and create very serious biliary problems such as recurrent pyogenic cholangitis, gall stones, and pancreatitis.2 Acalculous cholecystitis caused by Ascaris lumbricoides is also rare and seen in endemic areas.2,3
A 58 year old woman attended the emergency department with a one month history of right upper abdominal pain, vomiting, and fever. Her physical examination revealed tenderness in the right upper quadrant.
Laboratory test results at presentation revealed mildly increased liver enzymes aspartate transaminase:353 U/l, alanine transaminase:218 U/l, 
-glutamyltransferase:110 U/l, alkaline phosphatase:192 U/l, serum total bilirubin was normal. Blood haemoglobin concentration:12 mg/dl, packed cell volume:35.8%, and leucocyte count was 18x109/l with mild eosinophilia. Serum amylase level was within normal limits at admittance. Her stool examination was positive for A lumbricoides ova. A
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