28353561 Visualization

A 16 Age - year Age - old Age female Sex suffered from an abdominal Biological_structure pain Sign_symptom at right Biological_structure upper Biological_structure quadrant Biological_structure , lasting for more Duration than Duration 10 Duration days Duration .
Shortly ahead of her medical consultation Clinical_event , 4 Lab_value ascaris Detailed_description - like Detailed_description worms Detailed_description were vomited Sign_symptom out, individually with a length of about 10 Distance   cm Distance .
She had a previous Detailed_description onset Detailed_description of ascariasis Disease_disorder , during which low Lab_value - grade Lab_value fever Sign_symptom ( 38.4°C Lab_value ) occurred without apparent jaundice Sign_symptom , diarrhea Sign_symptom , or anemia Sign_symptom .
Physical Diagnostic_procedure examination Diagnostic_procedure revealed tenderness Sign_symptom at right Biological_structure upper Biological_structure quadrant Biological_structure .
Her total Diagnostic_procedure leukocyte Diagnostic_procedure count Diagnostic_procedure was 11.2 Lab_value   G/L Lab_value consisting of 5.2% Lab_value eosinophils Lab_value .
Serum Biological_structure and urine Biological_structure amylase Diagnostic_procedure were 386 Lab_value and 928 Lab_value   U/L Lab_value , respectively.
In terms of liver Diagnostic_procedure functionality Diagnostic_procedure , the level of total Diagnostic_procedure bilirubin Diagnostic_procedure rose Lab_value up Lab_value to 23.2 Lab_value   μm/L Lab_value , meanwhile the hepatic Diagnostic_procedure enzymes Diagnostic_procedure were similarly elevated Lab_value ( alanine Diagnostic_procedure aminotransferase Diagnostic_procedure 163 Lab_value   U/L Lab_value ; aspartate Diagnostic_procedure aminotransferase Diagnostic_procedure 96 Lab_value   U/L Lab_value ).
Abdominal Biological_structure ultrasound Diagnostic_procedure described the enlargement Sign_symptom of the gallbladder Biological_structure , upper Biological_structure segment Biological_structure of Biological_structure common Biological_structure bile Biological_structure duct Biological_structure ( 1.5 Distance   cm Distance in Distance diameter Distance ) and intrahepatic Biological_structure bile Biological_structure duct Biological_structure ( 1.3 Distance   cm Distance in Distance diameter Distance ).
Furthermore, the intrahepatic Biological_structure bile Biological_structure duct Biological_structure was also discovered to be filled with echogenic Sign_symptom and banded Sign_symptom substances Sign_symptom .
Based on such evidences, she was clinically diagnosed as biliary Biological_structure ascariasis Disease_disorder with a concomitant manifestation of biliary Biological_structure duct Biological_structure infection Disease_disorder .
Through a laparoscopic Diagnostic_procedure exploration Diagnostic_procedure , the enlarged Sign_symptom gallbladder Biological_structure and common Biological_structure bile Biological_structure duct Biological_structure were visually confirmed, as well as the massive Severity storage Severity of worms Sign_symptom within the biliary Biological_structure tract Biological_structure .
Subsequently, a 1 Distance   cm Distance incision Therapeutic_procedure was made on the common Biological_structure bile Biological_structure duct Biological_structure in order to facilitate the extraction Therapeutic_procedure of the pathogenic worms Sign_symptom , which were then placed Therapeutic_procedure into Therapeutic_procedure a Therapeutic_procedure specimen Therapeutic_procedure bag Therapeutic_procedure laparoscopically Detailed_description (Fig.1).
Once the contained worms Sign_symptom were virtually cleared out under laparoscope Diagnostic_procedure , chodedochoscopy Diagnostic_procedure was employed to seek for more hidden Detailed_description worms Sign_symptom inside the biliary Biological_structure system Biological_structure (Fig.2).
After finishing the removal Therapeutic_procedure of ascarides Coreference , the biliary Biological_structure duct Biological_structure incision Therapeutic_procedure was Therapeutic_procedure well Therapeutic_procedure sutured Therapeutic_procedure , with a T Therapeutic_procedure - tube Therapeutic_procedure placed Therapeutic_procedure in situ (Fig.3).
Eventually, a standard laparoscopic Detailed_description cholecystectomy Therapeutic_procedure was performed, followed by the removal Therapeutic_procedure of Therapeutic_procedure specimen Therapeutic_procedure bags Therapeutic_procedure and drainage Therapeutic_procedure tube Therapeutic_procedure placement Therapeutic_procedure (Fig.4).
The total amount of worms Sign_symptom inside the common Biological_structure bile Biological_structure duct Biological_structure summed up to more Lab_value than Lab_value 100 Lab_value (Fig.5).
Postoperatively, she was treated with oral Administration antihelminthic Medication drugs Medication for 3 Duration days Duration .
The T Therapeutic_procedure - tube Therapeutic_procedure was Therapeutic_procedure rinsed Therapeutic_procedure with Therapeutic_procedure saline Therapeutic_procedure every day, and during Duration the Duration first Duration 3 Duration days Duration , 6 Lab_value more worms Sign_symptom were additionally washed out.
The patient experienced a smooth Lab_value postoperative Therapeutic_procedure recovery Therapeutic_procedure and was finally discharged Clinical_event from Nonbiological_location hospital Nonbiological_location without any complications Sign_symptom .