الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 162 |  |  |
| | | from | 162 | | |
Abstract
The present study was planned to report the incidence of fascioliasis,hydatidosis, ascariasis and bilharziasis among patients with obstructive jaundice. It was conducted on 110 patients chosen from the National Liver Institute (ERCP unit) Menoufiya University.The range of age of all patients was 15-82 years, the median was 30 years. It was noticed that most parasitic infections in the present study occurred above the age of 30 years. Also the parasitic infections in relation to the sex of the patient showing that bilharzial infection was higher in males (83.3%) than females (16.7%), whereas in ascariasis the infection in females was higher (72.3%) than males (27.7%).All patients of the present study were classified according to the results of ERCP into benign causes (55 cases) including gallstones in 74.5%,strictures in 9 %, inflammatory masses in 7.3% and parasites inside the bile duct in 9.2% of benign causes. Malignant causes (55 cases) including cancer head of pancreas in 54.6%, cancer gallbladder in 25.5%,cholangiocarcinoma in 18% and HCC in 1.9% of malignant causes.
The results of the present study showed that the common manifestations of all patients with obstructive jaundice were as follows: 100% of patients had clinical jaundice, right upper quadrant pain in 66.2%, dark urine in 55.2%, itching in 54.5% and clay stool in 49% of cases.Ultrasonography results revealed that 64% of total cases ha hepatomegaly, 8 % had splenomegaly & conclusion 126.Endoscopic Retrograde Cholangio Pancreatography was used to detect the cause of obstruction which revealed that 69% had gallstones in bilharziasis and 37.5% in fascioliasis and 50% in ascariasis. 4.8%strictures in bilharziasis and 16.6% in ascariasis. 9.5% inflammatory masses in bilharziasis. Cancer head of pancreas in 7 % in bilharziasis,37.5% in fascioliasis and 22.2% in ascariasis. Gallbladder carcinoma was diagnosed in 9.5% in bilharziasis and 5.5% in ascariasis.The endoscopy diagnosed two patients of hydatid sand inside the bile duct, 2 living Fasciola worms inside the bile duct and one having living Ascaris worm inside the duct.All patients were subjected to stool examination which revealed that five patients were positive for bilharziasis, two with fascioliasis, 18 with ascariasis. Rectal Snip showed 13 positive patients for S. mansoni out of 42 positive for bilharziasis by IHAT.Indirect haemagglutination test for fascioliasis diagnosed eight positive patients and two with hydatidosis and schistosomiasis was positive in 42 patients.The percentage of eosinophilia (>2000 cells/ml) in different parasites was recorded as follows: in bilharziasis, 57.1% hydatidosis, 100% fascioliasis, 62.5 % and in ascariasis, 72.2%.