Hepatic Schistosomiasis japonica in a patient with gallstones and bile duct stones--a case report.
Schistosomiasis, a common parasitic disease in many countries, is found as imported cases in Taiwan. Responsible for human infections are five species, one of which, Schistosoma japonicum, is currently endemic in China and South-east Asia. Chronic infection with S. japonicum may lead to the development of liver fibrosis, calcification and portal hypertension. Under investigation by sonography and computed tomography (CT) scan, a peculiar "turtle-back" appearance of liver fibrosis and calcification may be found. Herein, we report a case referred to our department due to jaundice. The sonography of liver showed typical "turtle-back" appearance. Gallstones and bile duct stones were also found in this case. Surgical interventions with percutaneous transhepatic biliary drainage (PTBD), cholecystectomy and choledocholithotomy were performed to relieve the obstructive jaundice and remove the stones. There were no parasitic eggs in the extracted stones or in drained bile juice. However, deposits of calcified S. japonicum eggs in liver parenchyma and portal tracts were identified in liver biopsy. No special treatment was given for the schistosomiasis japonica because the calcified parasitic eggs were the sequelae of past infection.
Lin
J N
JN
Department of Emergency, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Yen
C M
CM
Liu
C S
CS
Tsai
M S
MS
Kuo
K K
KK
D000368:Aged; D001649:Bile Duct Diseases / Q000209:etiology*; D002769:Cholelithiasis / Q000209:etiology*; D002908:Chronic Disease; D006801:Humans; D008109:Liver Diseases, Parasitic / Q000150:complications* / Q000175:diagnosis; D008297:Male; D012554:Schistosomiasis japonica / Q000150:complications* / Q000175:diagnosis