<i>Ascaris lumbricoides</i> infestation of the gallbladder: case report

A 41-year-old woman presented with 3 days of right hypochondria and epigastric pain with vomiting. Laboratory results showed 4730 white blood cells, with eosinophils at 1.3% and C-reactive protein of 7.23 mg/L. We suspected hepatic colic. Ultrasonography revealed a long, floating, zigzagging tubular structure in the gallbladder, indicating the presence of a live worm. We concluded that the gallbladder was infested with <i>Ascaris lumbricoides</i>. The patient was treated with albendazole, leading to clinical improvement, and she was advised on prevention. Gallbladder infestation is a hepatobiliary complication of ascariasis. The worm appears as a mobile, zigzagging tubular structure within the gallbladder, resembling a "swimmer in the gallbladder." This appearance is easily recognizable on ultrasound and has been reported in cases of live <i>Ascaris</i>. In uncomplicated cases, antihelminthics may suffice. Monitoring is necessary because taking antiparasitic drugs can precipitate the onset of complications by retaining dead worms in the bile duct.