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A 40-year-old woman, native of the , who had return from his country 15 days before, was admitted for acute pancreatitis. Laboratory test showed leukocytosis, eosinophilia, mild hipertransaminasemia (< 90 mg/dL) and normal bilirubin. An abdominal ultrasound revealed a distended and thickened-wall gallbladder and, inside it, a long linear structure showed spontaneous wave movements (Fig. 1A). It stretched by the main bile duct from the gallbladder to the papilla (Fig. 1B). Because of this finding, albendazol was started and an endoscopic retrograde cholangiopancreatography (ERCP) was performed 24 hours later in order to remove the parasite. However, the papilla was torn and no parasite was seen inside bile duct. A new ultrasound and magnetic resonance imaging confirmed it. Patient fully recovered and was discharged.

Biliary parasite (Ascaris) as a cause of acute pancreatitis: Ultrasound diagnosis