Endoscopy-assisted emergency treatment of gastroduodenal and pancreatobiliary ascariasis.

Five patients with gastrointestinal tract and pancreatobiliary ascariasis presenting as emergency cases are reported here. Two patients presented with hematemesis due to gastric ascariasis, one with abdominal pain due to duodenal ascariasis, and one each with biliary and pancreatic ascariasis manifesting as acute cholangitis and acute pancreatitis, respectively. Endoscopy-assisted management consisted of roundworm removal using a Dormia basket, insertion of a biliary endoprosthesis, and carrying out endoscopic sphincterotomy alone or in combination, and was successful in all cases, with administration of albendazole. The condition of all the patients improved, and they have been asymptomatic on follow-up (2-12 months).