Abstract
BACKGROUND Taeniasis is a helminthic infection caused by the Taenia species, specifically T. solium, T. saginata, and T. asiatica. Generally, the parasites infect the small intestine; however, instances of atypical migration have also been reported. CASE REPORT A 47-year-old Thai woman presented to Nan Hospital with epigastric pain, nausea, and vomiting. Physical examination revealed tenderness in the right upper quadrant, and laboratory analysis revealed mild direct hyperbilirubinemia. Abdominal ultrasonography revealed multiple gallstones and acute cholecystitis. During an elective cholecystectomy, a 70-cm-long tapeworm was found in the gallbladder. Histological examination confirmed the presence of parasitic infection suggestive of Taenia spp., with acute inflammation and focal mucosal necrosis of the gallbladder. Microscopic examination revealed 20 to 22 uterine branches in each of the 5 gravid proglottids, with 42 to 55 uterine twigs and an average ratio of uterine twigs to branches of 2.41, confirming that the parasite in question was possible for T. saginata or T. asiatica. The patient's symptoms resolved after surgery. She was prescribed an oral antibiotic and antiparasitic drug after the operation and experienced no post-surgical complications. CONCLUSIONS Certain parasitic worms can migrate from the intestine to the biliary system. Although less common, T. solium, T. saginata, and T. asiatica can also be detected in the gallbladder and cause acute cholecystitis. This case stresses the potential for misdiagnosis in imaging studies and advises clinicians in endemic areas to consider Taenia spp. infections in the biliary system.