Fig. 14

Ascariasis. a. Barium fluoroscopic study of a 24-year-old woman from Ecuador with previous history of ascariasis and presenting with abdominal pain, diarrhoea, and anaemia. The study shows a worm inside a jejunal loop (arrows). The faeces examination revealed ascaris eggs and the patient was successfully treated with mebendazole. Note that the head (blunt) of the worm points proximally (arrowhead), as is usual in this parasite b. Barium fluoroscopic study of a 37-year-old male from Ecuador presenting with intermittent episodes of right lower quadrant pain, mild vomiting, diarrhoea, and fever. Stool parasitic study revealed ascaris eggs. The barium examination shows intestinal worms compatible with ascaris, note that the shown worm has swallowed barium contrast (arrows). c and d. 29-year-old woman from Ecuador with previous surgery of cholecystectomy, presenting with biliary vomiting, right upper quadrant pain, and elevated liver and cholestatic enzymes. The US examination in C displayed a long echogenic filling defect without acoustic shadowing inside the common bile duct (CBD) (arrows), with other adjacent smaller filling defects compatible with gallstones and/or debris. The ERCP in B shows a worm inside the common bile duct whose head is introduced in the right hepatic duct (arrows). The living worm was extracted with ERCP and proved to be an ascaris lumbricoides