Гепатобилиарный и панкреатический аскаридоз. Клинический случай рецидивирующего панкреатита паразитарного происхождения у ребенка: КЛИНИЧЕСКИЙ СЛУЧАЙ

Светлана Николаевна  Дроздова; Мария Евгеньевна  Балакина; Елена Александровна  Корниенко; Екатерина Леонидовна  Моисейкова

doi:10.56871/PED.2025.16.60.011

Hepatobiliary and pancreatic ascariasis. A clinical case of recurrent pancreatitis of parasitic origin in a child

CLINICAL OBSERVATION

Svetlana N. Drozdova Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Maria E. Balakina Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Elena A. Kornienko Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Ekaterina L. Moiseikova Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia

Keywords:

аскаридоз гепатобилиарный и панкреатический аскаридоз рецидивирующий панкреатит ascariasis hepatobiliary and pancreatic ascariasis recurrent pancreatitis

Abstract

Hepatobiliary and pancreatic ascariasis (HPA) is a rare complication of Ascaris lumbricoides infection, one of the most common helminths worldwide. In the Russian Federation, ascariasis is the second most prevalent parasitic disease, and children are the primary risk group. However, HPA as a cause of chronic pancreatitis in pediatrics is extremely rare, with the overall incidence of chronic pancreatitis among children being only about 0.5–1 case per 100,000. This rarity creates significant diagnostic challenges and leads to prolonged unsuccessful treatment. The article describes a clinical case of recurrent chronic pancreatitis in a 6-year-old girl. Over several years, the patient was repeatedly hospitalized with acute biliary pancreatitis. The examination ruled out cholelithiasis, ductal anomalies, and autoimmune or hereditary pancreatitis. During the diagnostic workup, an endoscopic ultrasound-guided fine-needle aspiration biopsy of the pancreas was performed; cytological examination of the aspirate revealed findings consistent with possible parasitic infestation. Despite negative serological tests for ascariasis, key findings included eosinophilia and an endosonographic image of a cluster of cylindrical calcifications in the terminal part of the Wirsung’s duct, interpreted as a result of calcification of a dead helminth. This case underscores that in children with idiopathic recurrent pancreatitis, the possibility of a past parasitic infection must be considered. A comprehensive diagnostic approach should include not only serology but also morphological examination and high-resolution imaging of the ductal system.

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