All of the following causes biliary obstruction except:

Ans. (c) Ankylostoma duodenale Hepatobiliary Parasitism Common in Southern China Biliary tract is infestated by adult helminths or their ova Causes: (a) Trematodes (Liver or biliary flukes) MC Clonorchis sinensis Opisthorchis viverrini or 0. felineus Fasciola hepatica (b) Nematode (Ascaris lumbricoides by intraductal migration of adult worm) (c) Cestodes (Echinococcus by intrabiliary rupture of hydatid cyst) Clinical Features: Chronic/recurrent pyogenic cholangitis +- multiple hepatic abscess Ductal stones Biliary obstruction Diagnosis: Cholangiography Characteristic ova on stool examination Treatment: If obstruction is present, TOC is laparotomy under antibiotic coverage with common duct exploration and biliary drainage procedure. Helminths causing obstructive jaundice are: Ascaris, Clonorchis, Fasciola, Echinococcus.