The clinical and cholangiographic picture of hepatic clonorchiasis.
BACKGROUND
Hepatic clonorchiasis is endemic in areas of the Far East, including Taiwan, where people commonly eat raw or partially cooked freshwater fish.


OBJECTIVE
To analyze and explore the cholangiographic findings of hepatic clonorchiasis with respect to the clinical data.


METHODS
From February 1990 to May 1999, 64 patients were diagnosed with hepatic clonorchiasis in the Kaoshiung Veterans General Hospital. Eighteen of the 64 patients were indicated for endoscopic retrograde cholangiopancreatography (ERCP). The final diagnosis was confirmed by identification of ova in bile or worms in the biliary tract.


RESULTS
Fifteen (83%) of 18 patients had history of raw fish consumption and seven patients (39%) came from an endemic area. Clinically, cholangitis (8 of 18) was the most frequent indication for ERCP. All of the patients were diagnosed by the presence of ova in bile. Only seven (39%) patients had peripheral eosinophilia, and seven (39%) had ova in stool. The most characteristic cholangiographic finding of hepatic clonorchiasis in ERCP is filamentous or elliptic filling defects of the biliary tract (16 of 18).


CONCLUSIONS
When presented with biliary symptoms, a history of raw fish consumption in an endemic area should arouse suspicion of hepatic clonorchiasis. Filamentous filling defects in ERCP with bile analysis may confirm the diagnosis.
Chan
Hoi-Hung
HH
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, National Yang Ming University, Taiwan, ROC.
Lai
Kwok-Hung
KH
Lo
Gin-Ho
GH
Cheng
Jin-Shiung
JS
Huang
Jia-Sheng
JS
Hsu
Ping-I
PI
Lin
Chiun-Ku
CK
Wang
E-Ming
EM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002758:Cholangiography; D003003:Clonorchiasis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008109:Liver Diseases, Parasitic / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged