Question

Which one of the following parasites may cause suppurative cholangitis?

• A. Ankylostoma duodenale
• B. Ascaris lumbricoides
• C. Necator americanus
• D. Trichuris trichiura

Hint:

Think of the large roundworm known to migrate into the bile duct.

Answer 1

The Correct Option is B

Step 1: Understanding the Question:
We need to identify which intestinal worm is known to invade the bile ducts and cause suppurative (pus forming) cholangitis.

Step 2: Key Formula or Approach:
Of the common intestinal helminths, only one is large enough and has the right life cycle to travel up the biliary tree from the duodenum through the ampulla of Vater.

Step 3: Detailed Explanation:
Ascaris lumbricoides is a large roundworm that lives in the small intestine and can migrate into the common bile duct, especially in areas where the infection is heavy or during fever or after some abdominal surgeries. Once inside the biliary tree, it can obstruct bile flow, carry bacteria in with it, and cause cholangitis, sometimes with pus formation, along with biliary colic and even pancreatitis in some cases. Ankylostoma duodenale (hookworm) and Necator americanus (the other hookworm) mainly cause blood loss and iron deficiency anemia by attaching to the small intestinal wall, they do not travel into the biliary tree. Trichuris trichiura (whipworm) stays in the large intestine, mainly the cecum, and is linked to diarrhea and rectal prolapse in heavy infection, not biliary disease.

Step 4: Final Answer:
Ascaris lumbricoides is the parasite that may cause suppurative cholangitis, option (B).