Incidencia de Áscaris en vía biliar y factores asociados en pacientes que acuden al Hospital General Macas. Agosto 2015- junio 2016

Abstract

Introduction: The intestinal ascaridiasis is sometimes complicated by the migration of the parasite to the hepatobiliary pathway or to the gallbladder, giving symptoms similar to that of cholecystitis or choledocholithiasis. The endoscopic cholangiopancreatography (ERCP), computerized axial tomography (CT), and mainly ultrasound are among the main means to reach the diagnosis. Materials and methods: An observational, descriptive, cross-sectional study was conducted with a sample of 183 patients who attended to the Macas General Hospital due to upper abdominal pain. A validated questionnaire was applied to obtain data on the sociodemographic, clinical and ultrasound characteristics of the patients. A descriptive univariate and bivariate analysis was performed. The association was determined with the chi square test. Statistically significant results were considered at values of p <0.05. Results: The majority of patients were between 19- 44 years old, everybody were women of the Shuar ethnic group, with low socioeconomic status and extreme poverty. More than half of the population studied does not have drinking water, very few people reported surgical history, and a quarter of the sample analyzed expressed expulsion of worms. The main symptoms for which the patients attended were: nausea, vomiting, abdominal pain and thermal rise. The incidence of ascaris in the biliary tract was 29.0%, with 13.2% of complications, mainly pancreatitis and hepatic abscess. There was an association with thermal rise; however, sex, drinking water consumption, surgical history and nutritional status were not associated with the disease. Conclusions: the incidence of ascariasis is high and it is associated with thermal rise as a risk factor for migration of the parasite to the bile ducts.