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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, γ-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 18×109/l with mild eosinophilia. Serum amylase level …