Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2020; 8(19): 4499-4504
Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4499
Ascaris-mimicking common bile duct stone: A case report
Seo-Youn Choi, Ha Eun Jo, Yun Nah Lee, Ji Eun Lee, Min Hee Lee, Sanghyeok Lim, Boem Ha Yi
Seo-Youn Choi, Ha Eun Jo, Ji Eun Lee, Min Hee Lee, Sanghyeok Lim, Boem Ha Yi, Radiology, Soonchunhyang University Hospital, Bucheon, Bucheon 14584, South Korea
Yun Nah Lee, Digestive disease center and research institute, Soonchunhyang University Hospital, Bucheon, Bucheon 14584, South Korea
Author contributions: Jo HE and Choi SY conceptualized the case report; Lee YN performed investigation; Lee JE, Lee MH, and Lim S curated data; Jo HE and choi SY wrote original draft; Lee YN, Lee JE, Lee MH, Lim S, and Yi BH have reviewed and edited the original draft; All authors have approved the final manuscript.
Supported by Soonchunhyang University Research Fund, No. 20200019.
Informed consent statement: This case report was approved by the institutional review board at our institution. The need for informed consent was waived.
Conflict-of-interest statement: The authors state that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Seo-Youn Choi, MD, PhD, Assistant Professor, Radiology, Soonchunhyang University Hospital, Bucheon, 170 Jomaru-ro, Kyeong-gi do, Bucheon Si, Republic of Korea, Bucheon 14584, South Korea. sychoi@schmc.ac.kr
Received: July 1, 2020
Peer-review started: June 30, 2020
First decision: July 24, 2020
Revised: August 4, 2020
Accepted: August 26, 2020
Article in press: August 26, 2020
Published online: October 6, 2020
Processing time: 88 Days and 21.2 Hours
Abstract
BACKGROUND

In most cases, it is not difficult to differentiate common bile duct (CBD) stone from Ascaris infection because they are different disease entities and have different imaging findings. The two diseases usually demonstrate unique characteristic findings on computed tomography or magnetic resonance cholangiopancreatography. However, we report a rare case from our experience in which a CBD stone mimicked and was misdiagnosed as Ascaris.

CASE SUMMARY

A 72-year-old male presented with elevated serum liver enzymes. Computed tomography showed a hyper-attenuated, elongated lesion in the CBD lumen and associated biliary inflammation. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography revealed a linear filling defect in the bile duct. Moreover, elongated echogenic material with a central hypoechogenic area was seen on endoscopic ultrasound. Although the imaging findings caused us to suspect infection with the nematode Ascaris, the lesion was revealed to be a dark-brown-colored CBD stone through endoscopic extraction.

CONCLUSION

We report a rare case of a CBD stone that mimicked Ascaris. We also review the literature for side-by-side comparisons of the imaging features of CBD stones and ascariasis.

Keywords: Case report; Common bile duct; Gallstones; Ascaris; Ascariasis; Multidetector computed tomography; Magnetic resonance cholangiopancreatography

Core Tip: Although common bile duct stone and Ascaris are not commonly discussed as differential diagnosis each other, they can be misunderstood in case of the elongated common bile duct stone. We should be able to learn the differential points through this case.