<prompt> All of the following causes biliary obstruction except:ClonorchisAscarisAncylostoma duodenaleFasciola  <response>: 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: Chronicrecurrent 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. 