[Massive hepatobiliary fascioliasis].
Massive hepatobiliary fascioliasis. Report of two cases.


BACKGROUND
Liver fascioliasis is the most frequent parasitic disease of the biliary tract in Mexico. Massive infestation is common in sheep and bovines and rarely occurs in humans. Only two previous cases of massive fascioliasis has been reported and we present here in two additional cases. Case reports. Both cases presented in alcohol-related liver disease patients who had eaten watercress Nasturium officinalis. Upper abdominal pain, obstructive jaundice, and choledochal dilatation were the salient manifestations. Diagnosis was made by surgical exploration and adult fluke identification. One patient died due to progressive liver failure and the other, is alive and received praziquantel treatment.


CONCLUSIONS
Since 1935, approximately fifty cases of massive hepatobiliary fascioliasis have been reported in Mexico, most misdiagnosed as cholelithiasis; however, a history of watercress ingestion has been recorded in most of these cases.
Sánchez-Sosa
S
S
Servicio de Cirugía, Hospital ISSSTEP. sergisanchez@compuserve.com
Rojas-Ortega
S
S
Reed-San Roman
G
G
Torres-Santana
M A
MA
D000368:Aged; D000369:Aged, 80 and over; D000871:Anthelmintics / Q000627:therapeutic use; D002764:Cholecystitis / Q000150:complications; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005211:Fascioliasis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D005506:Food Contamination; D016266:Food Parasitology; D006801:Humans; D006973:Hypertension / Q000150:complications; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D017093:Liver Failure / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010945:Plants, Edible / Q000469:parasitology; D011223:Praziquantel / Q000627:therapeutic use
D000871:Anthelmintics; D011223:Praziquantel