Round worm pancreatitis: Endoscopic worm removal without papillotomy

Ascaris lumbricoides is a common parasitic infestation in the human gastrointestinal tract. Complications occur when the worm migrates through the orifices and ducts. Ascariasis has been shown to cause cholangitis, pancreatitis, and even perforation of the bile duct. Biliary ascariasis is usually managed by surgery although endoscopic removal of the worm from the bile duct at duodenoscopy has been reported. We report a case of recurrent pancreatitis due to biliary ascariasis with successful endoscopic removal of the worm through an intact papilla.