Finding of Biliary Fascioliasis by Endoscopic Ultrasonography in a Patient with Eosinophilic Liver Abscess

• Main Authors: Catherine Behzad, Farhad Lahmi, Majid Iranshahi, Amir Houshang Mohammad Alizadeh
• Format: Article
• Language: English
• Published: Karger Publishers 2014-10-01
• Series: Case Reports in Gastroenterology
• Subjects: Magnetic resonance cholangiopancreatography; Endoscopic ultrasonography; Endoscopic retrograde cholangiopancreatography; Fasciola hepatica
• Online Access: http://www.karger.com/Article/FullText/367592

Fascioliasis is an endemic zoonotic disease in Iran. It occurs mainly in sheep-rearing areas of temperate climates, but sporadic cases have been reported from many other parts of the world. The usual definitive host is the sheep. Humans are accidental hosts in the life cycle of Fasciola. Typical symptoms may be associated with fascioliasis, but in some cases diagnosis and treatment may be preceded by a long period of abdominal pain and vague gastrointestinal symptoms. We report a case with epigastric and upper quadrant abdominal pain for the last 6 months, with imaging suggesting liver abscess and normal biliary ducts. The patient had no eosinophilia with negative stool examinations, so she was initially treated with antibiotics for liver abscess. Her clinical condition as well as follow-up imagings showed appropriate response after antibiotic therapy. Finally, endoscopic ultrasonography revealed Fasciola hepatica, which was then extracted with endoscopic retrograde cholangiopancreatography.