I. Diagnostic Key Points

I. Diagnostic Key Points

(1) Sudden onset of severe, paroxysmal colicky pain in the upper abdomen, radiating to the back and right scapula, with pain so intense it is almost unbearable, accompanied by a "drilling" sensation that causes the patient to writhe and toss about. Often accompanied by nausea and vomiting, or even expulsion of the roundworms. During remission, the pain may completely disappear.

(2) Physical examination reveals only mild tenderness in the right upper quadrant or below the xiphoid process, or deep tenderness, with the abdominal wall typically soft and lacking rigidity, inconsistent with the severity of the pain.

(3) Laboratory tests: White blood cell count may be slightly elevated, with eosinophils often increased. If there is concurrent infection of the biliary system, body temperature and pulse rate will also show corresponding changes.

(4) Ultrasound examination: Roundworm bodies can be observed within the biliary tract.