Journal List > Korean J Gastroenterol > v.64(5) > 1007301

Kim, Jung, Her, Hur, Choi, Kang, and Hwang: A Case of Fascioliasis in the Intrahepatic Duct with Concurrent Clonochiasis

Abstract

The main causes of biliary obstruction are stones and cancers. Fascioliasis is a very rare case which causes biliary obstruction. Fascioliasis is a zoonosis caused by Fasciola hepatica which infects herbivores like sheep and cattle. F. hepatica lives in the biliary system or the liver parenchyma of a host. In Korea, the occurrence of this infection in human is very rare and only few cases have been reported. A 32-year-old male presented with upper abdominal pain and jaundice. His laboratory finding revealed elevated liver transaminases. Abdomen CT scan showed mild left intrahepatic bile duct dilatation. On ERCP, adult F. hepatica worms were found and were thus removed. Concurrently, clonorchiasis was diagnosed by stool exam and serologic enzyme-linked immunosorbent assay test. Clonorchiasis was treated with praziquantel. Herein, we report a case of intrahepatic bile duct dilatation due to F. hepatica infection with concurrent Clonorchis sinensis infestation.

References

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Fig. 1.
Abdomen computed tomography scan findings. On (A) coronal reconstructed image and (B) axial scan, mild left intrahepatic bile duct dilatation is noted but no definite obstructive lesion is observed (arrows).
kjg-64-298f1.tif
Fig. 2.
Endoscopic retrograde cholangiopancreatography shows multiple filling defects (arrows) in the left intrahepatic bile duct.
kjg-64-298f2.tif
Fig. 3.
(A) The adult Fasciola hepatica worms were removed by endoscopic balloon catheter sweeping from the left intrahepatic bile duct. (B) Three adult F. hepatica worms measuring abount 25–30 mm in length are shown.
kjg-64-298f3.tif
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