This is a clinical analysis of 39 cases of biliary ascariasis, which were treated at the Surgical department of S.N.U.H. during the 7.5 year periods from October, 1967 to March, 1975. And the results were summarized as follows.
1. Occurrence
1) Age and sex distribution
The sex ratio was 1: 3.9 of female preponderance and 3rd decade was the most prev-alent age group (33:3%), followed by 4th (28.2%) and 5th decade (18%). 2) Seasonal occurrence
The disease was most prevalent in winter (33%), followed by spring (30.7%) and fall (25.7%).
2. Symptoms and signs
1) Duration of recent symptoms
The groups which were admitted within 1-7 days of onset was 38.5% and those admitted within 15-30 days of onset was 33.3%.
2) Body temperature at admission
The most prevalent range of body temperature at admission was that of within normal limit, which was 61. 1% and the next was within the range of 37-38´C, which was 33.3%. 3) Symptoms
The patients who complained of vomiting was 69.2% and those who complained of radiating pain was 71.8%.
3. Laboratory findings
1) WBC count
36.1% of patients showed normal leukocyte count and 33.3% showed 3,000-6,000 leukocyte count.
And the cases which showed cosinophilia were 56.4% and those who showed neutrophilia were 74. 3%.
2) Other lab. findings
56.4% of patients showed mild increase in Alk. Ease level, and 30.7% of patients showed increased levels in bilirubin which were seemed to rise chiefly in patients with associated
biliary tract diseases.
4. The main preoperative diagnosis was gall stone (53.9%) and the correct preoperative diagnosis was possible only in 5 cases (12.8%), which were confirmed by demonstration of ascarids in the biliary tree on IV cholangiography.
5. 77% of patients were taken -cholecystectomy and T-tube choledochostomy and 20.5% of patients were taken T-tube choledochostomy only. And associated operations were done, such as sphincteroplasty, hepatotomy, drainage of the pancreatic abscess.
6. The ascarids were found in CBD in 34 cases(87.2%) and those found in gall bladder and those found from gall bladder through CBD were 5 cases (12.5%), and a case was found in the intrahepatic biliary tree.
7. Live ascarids were found in 46.2% of cases and dead ones were found in 30.7% of cases. And 37 cases (94.9%) of patients had one ascarid and two cases had two ascarids.
Both sexes of ascarids were found as etiologic agents.
8. 46.2% of patients rad associated biliary tract diseases and those are 10 cases 025.6%) of CBD stone, 4 cases (10.3%) of gall stone respectively.
9. 48.6% of patients were discharged from hospital during the 15-21 postop days. And 25.7% of patients were discharged during the 11-14 postop days.
|