A Case of Fascioliasis in the Intrahepatic Duct with Concurrent Clonochiasis

Seung-Hyun Kim; Chang-Kil Jung; Jin Her; Ki-Hwan Hur; Jae-Hyuc Choi; Kee-Hoon Kang; Chan-Hee Hwang

doi:10.4166/kjg.2014.64.5.298

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

Case Report

Korean J Gastroenterol 2014;64(5):298-301.

Published online: 4 October 2014

DOI: https://doi.org/10.4166/kjg.2014.64.5.298

A Case of Fascioliasis in the Intrahepatic Duct with Concurrent Clonochiasis

Seung-Hyun Kim, Chang-Kil Jung, Jin Her, Ki-Hwan Hur, Jae-Hyuc Choi, Kee-Hoon Kang, Chan-Hee Hwang

Department of Internal Medicine, Dongkang Medical Center, Ulsan, Korea

Correspondence to: Chang-Kil Jung, Department of Internal Medicine, Dongkang Medical Center, 239 Taehwa-ro, Jung-gu, Ulsan 681-711, Korea. Tel: +82-52-240- 1201, Fax: +82-52-241-1180, E-mail: sky8170@lycos.co.kr

Received 26 March 201412 May 2014 Accepted 16 May 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Fascioliasis, Clonorchiasis, Endoscopic retrograde cholangiopancreatography, Intrahepatic bile duct

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).

Fig. 2.

Endoscopic retrograde cholangiopancreatography shows multiple filling defects (arrows) in the left intrahepatic bile duct.

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.

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