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Gastric Outlet Obstruction Due to Extraluminal Compression: An Unusual Etiology

Case reports

Abstract

Ascariasis caused by the nematodeAscaris lumbricoides is a very common disorder amongst the Asian population. Adult roundworms are generally found in the intestine. But their agility often takes them through different orifices into ducts and cavities. Hepatobiliary and pancreatic ascariasis (HPA) refers to a group of diseases caused by migration of the Ascaris from the intestine into the biliary tree and pancreatic duct through the ampulla of Vater. Depending on the position of the nematode, HPA has widespread manifestations like biliary colic, acalculous cholecystitis, obstructive jaundice, cholangitis, pancreatitis and liver abscess. Surgical interventions are rarely required as approximately 95% of the patients with uncomplicated biliary ascariasis respond to conservative management. Ultrasonography of the  abdomen, CECT  &  ERCP  all  can  demonstrate  ascaris  as linear  filling  defect . Here  we   present  a  case  that   presented  with  features  of  acute  gastric  outlet  obstruction   and  obstructive  jaundice   as   a  result  of   extraluminal  antral  compression by  a  worm ball.