Periampullary carcinoma following biliary ascariasis--a case report.

A 42 year old man presented with obstructive jaundice and cholangits. Ultrasonography (USG) revealed dilated intrahepatic biliary radicals and common bile duct (CBD). The bile duct also showed a curvilinear parallel intraluminal structure suggesting biliary ascariasis. The CBD was explored and a dead worm removed but jaundice persisted. Endoscopic retrograde cholangio pancreaticography (ERCP) was done showing a periampullary mass which on biopsy showed a villous adenoma with highly dysplastic changes. A Whipple's pancreaticoduodenectomy was performed and the growth proved to be a well differentiated periampullary adenocarcinoma.