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The Surgeon and the Worm

Paul E. Sauer, MD; Church E. Murdock Jr., MD; James H. Erwin, MD; Howard S. J. Walker Jr., MD
Arch Surg. 1968;97(4):595-600. doi:10.1001/archsurg.1968.01340040091018.
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IN 1963 we were confronted with a complication of ascaris infestation necessitating biliary tract surgery. The case was considered an interesting oddity. However, the same problem was thrust upon us again in 1966. We realize now that surgical complications of Ascaris lumbricoides are not rare and must play a respectable role in surgical diagnosis. Reference to this problem is infrequent in American surgical literature.

This paper will review the epidemiology and surgical implications of the ascaris, and will explore in depth the problem of biliary ascariasis.

Epidemiology  Ascaris lumbricoides, world wide in distribution, is the most common parasite to infest man who is the only susceptible host.1-5The significant area of endemia in the United States is the southeast where the infestation rate may be 50%.1,3,6 While children are the most frequent victims, adults are not spared and both urban and rural populations may play host to


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