A rare cause of biliary pain in Belgium

Ascaris lumbricoides is the most frequent human helminthic parasite. Usually human ascariasis is poorly symptomatic but complications can arise due to worm migration. Erratic worm migration into the biliary tree is a rare but threatening condition regarding the associated complications : cholecystitis, pancreatitis, obstruction of bile ducts, liver abcesses and recurrent pyogenic cholangitis. We describe a case of a young Belgian women suffering from recurrent biliary colics over a period of eight months with repeated normal ultrasound findings. ERCP proved being the only effective diagnostic procedure for a living biliary worm, which was successfully removed with a balloon catheter.