In a rare case, doctors at Fortis Hospital here said they removed 14 live round worms, measuring 15-20 cm each, from a 38-year-old woman's bile duct, the duct which connects the liver and the intestines.

All the worms were removed endoscopically without surgery, said a statement released by Fortis Hospital, Shalimar Bagh, on Tuesday. While it is common to find worms in intestines, they are rarely found in the bile duct. "Usually round worms are found in the intestines. Occasionally they can migrate to the bile duct causing pain, fever and jaundice. There have been cases where we have seen two or three round worms in the bile duct. However, to see fourteen worms is extremely rare," said Arvind Khurana, head of the hospital's Gastroenterology Department.

The patient came to the hospital with complaints of severe abdominal pain, fever, vomiting and intermittent episodes of jaundice for the past six months. 
The patient was advised to undergo an abdominal CT scan which revealed the presence of worms in the bile duct. The patient then underwent an endoscopic procedure which revealed multiple live round worms, each measuring nearly 15 to 20 cm. The team of doctors led by Khurana removed all the worms using snares and forceps. 

"The patient had taken a second opinion at other hospitals which had misdiagnosed the condition and prescribed antibiotics for the pain. Once properly diagnosed, we managed to remove all the round worms endoscopically in a single session. Immediately after the removal the patient was pain free," Khurana added.Round worms can infest the human gut, where they feed and reproduce. The roundworm life cycle begins when the eggs from the adult worms living in the intestine are passed out with the faeces. This leads to the contamination of the soil. These infections are mostly seen in rural areas with poor sanitation and where contaminated soil is used as a fertiliser for fruits and vegetables.India has one of the highest number of cases related to worms as de-worming medication is not routinely administered, the statement added.