A case report of acute liver failure caused by biliary ascariasis in children

Most patients with biliary ascariasis present with acute abdominal pain and biliary colic. Typically, conservative treatment involving deworming agents is employed. However, for those who do not respond to pharmacological therapy, endoscopic or surgical intervention becomes necessary. Generally, the mortality rate is low, and the prognosis is favorable. This case describes a pediatric patient exhibiting symptoms of intestinal disease, including upper abdominal pain and jaundice, resulting from extrahepatic biliary tract obstruction caused by roundworms. This condition subsequently led to complications such as obstructive jaundice and acute liver failure. Abnormal signals within the gallbladder cavity were detected through imaging techniques, including abdominal magnetic resonance cholangiopancreatography (MRCP) and enhanced abdominal computed tomography (CT). These abnormalities typically manifest as strip-shaped, tortuous, and tubular filling defects, thereby confirming the diagnosis of biliary ascariasis. Following the oral administration of albendazole for deworming and DPMAS treatment for acute liver failure, the child's condition improved, and he was discharged from the hospital. Subsequent follow-up indicated no recurrence of the disease. The objective of this study is to facilitate the early identification of biliary ascariasis in children, actively manage associated complications, and prevent the development of severe conditions.