Hepatobiliary fascioliasis in non-endemic zones: A surprise diagnosis

Jha, Ashish K.; Goenka, Mahesh Kumar; Goenka, Usha; Chakrabarti, Amrita

doi:10.1016/j.ajg.2012.12.005

Cited by 7 publications

(12 citation statements)

References 4 publications

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“…F. buski remains a public health problem in endemic regions . Because of population migration and international food trade, human fascioliasis is an increasingly recognized entity in nonendemic zones …”

Section: Discussionmentioning

confidence: 99%

“…7 Because of population migration and international food trade, human fascioliasis is an increasingly recognized entity in nonendemic zones. 8 The lifecycle of F. buski requires mammalian final hosts (human or pigs), snails (intermediate host), and aquatic plants such as water chestnut, water caltrop, lotus, bamboo, and other edible water plants. The monoecious adult worms live in the proximal small gut of humans and pigs.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic diagnosis of Fasciolopsis buski: Revisited (with video)

Jha

2019

JGH Open

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Fasciolopsis buski is the largest fluke parasitizing the human small intestine. F. buski infections are not uncommon in Southeast Asia. The risk factors of F. buski infection mainly include eating of raw aquatic crops and infected snails. Most infections are asymptomatic. Heavy infection can be fatal as the flukes cause extensive intestinal inflammation, intestinal perforation, small bowel stricture, ulceration, hemorrhage, and abscess formation. Endoscopic diagnosis of this parasite has been described in a few case reports. Here, we describe and illustrate the endoscopic removal of F. buski from the stomach and duodenum.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic diagnosis of Fasciolopsis buski: Revisited (with video)

Jha

2019

JGH Open

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“…The diagnosis of fascioliasis is often delayed due to non-specific radiological and clinical findings. Patients infected with F. hepatica are typically admitted with symptoms of biliary colic, liver abscess, choledocholithiasis, pancreatitis, and compressive symptoms mimicking cholangiocarcinoma (11,12,14). ERCP can be performed for the differential diagnosis and definitive treatment of F. hepatica, thus avoiding further surgery (16).…”

Section: Discussionmentioning

confidence: 99%

“…The utility of ERCP in the treatment of biliary system parasites differs according to parasite type and intervention timing. For example, parasite extraction provides a therapeutic option for F. hepatica if antimicrobial therapy fails to completely eradicate biliary system parasites (10)(11)(12)(13)(14). Moreover, ERCP provides a bridge to safe surgery for Echinococcus granulosus by extracting vesicles from the biliary channel preoperatively.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography for biliary system parasites

et al. 2018

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Objective: Endoscopic retrograde cholangiopancreatography may be useful in the diagnosis and management of biliary system parasites. Material and Methods: Investigators retrospectively evaluated patients with biliary system parasites who underwent endoscopic retrograde cholangiopancreatography procedures over an eight-year period. We collected data regarding patient demographics, clinical features, and parasite type. We aimed to determine the utility of endoscopic retrograde cholangiopancreatography as a diagnostic and therapeutic intervention in patients with biliary system parasites. Results: We identified 22 patients with biliary system parasites from a total of 3,450 endoscopic retrograde cholangiopancreatography procedures performed during an eight-year period. Parasite types included Echinococcus granulosus (n=19), Fasciola hepatica (n=2), and Ascaris lumbricoides (n=1). Fifteen patients with liver hydatid cysts underwent endoscopic retrograde cholangiopancreatography prior to surgery due to obstructive jaundice. The endoscopic retrograde cholangiopancreatography procedure enabled definitive treatment without the need for surgery in the remaining two patients. Two patients with fascioliasis underwent endoscopic retrograde cholangiopancreatography due to clinical presentation of cholangitis, cholecystitis, and obstructive jaundice, leading to presumptive diagnosis of cholangiocarcinoma. However, the final diagnosis was made using endoscopic retrograde cholangiopancreatography following inspection of flat, leaf-shaped, motile flukes extracted from the bile duct. In one patient with ascariasis, a longitudinal tubular structure was identified in the bile duct; emergency surgery was required. Conclusion: The diagnosis of parasitic diseases is clinically challenging, and definitive diagnosis requires endoscopic retrograde cholangiopancreatography in some cases. Moreover, endoscopic retrograde cholangiopancreatography provides a therapeutic option for ascariasis, fascioliasis, and some forms of hydatidosis. Accordingly, the use of endoscopic retrograde cholangiopancreatography may change preoperative management and treatment strategies for biliary system parasite infections.

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“…Fascioliasis, a liver fluke infection caused by Fasciola hepatica , is one of the rarer causes of liver abscesses1. Differentiating these infections from the more common pyogenic and amoebic liver abscesses can be difficult.…”

Section: Introductionmentioning

confidence: 99%