Treatment of Biliary Ascariasis
The principle is to relieve spasm and pain, early deworming, and anti-infection.
Atropine 0.5 mg plus promethazine 25 mg, intramuscular or intravenous injection. Most worms exit from the biliary tract.
Deworming can be done orally with albendazole or mebendazole. Antibiotics should be used appropriately if fever occurs. ERCP has both diagnostic and worm-removal effects.
Surgical treatment is required for complications such as acute suppurative cholangitis, liver abscess, or hemorrhagic necrotizing pancreatitis.<Deworming>