Biliary ascariasis combined with a villous tumor of the papilla. Diagnostic and therapeutic value of endoscopy.

A 64-year-old man admitted for cholangitis presented with an ascaris lumbricoides in the biliary duct and a villous tumor of the ampulla of Vater. ERCP revealed the parasite as a "rail-like" linear defect in the main bile duct, and permitted its extraction. The ampullary tumor was repeatedly ablated with a snare and finally surgically removed because of suspicion of malignancy. This is the first report on such an association.