[Hepatic subcapsular hematoma caused by fascioliasis].
The case of a 22 year old woman from Huaraz is presented herein. She suffered from pain at right hypocondrium, associated to nausea and vomits, which intensified three days prior to admission. Upon examining her, a faded gallbladder murmur was found on the base of the right hemithorax. There is pain in the abdomen when touched at the epigastrium and right hypocondrium. The liver is perceived 3 cm beneath the costal edge: White blood count with severe eosinophilia. Mild cholestasis is observed. Abdominal scan: Heterogeneous hepatic mass, with a 13 cm diameter in the right lobe. CAT scan: Subcapsular 14x8 cm mass. Scintiscan: Liver with a low absorption area showing absence of perfusion to the vascular pool. She undergoes an exploratory laparotomy and an 800 cc subcapsular hematoma is found in segment 6, 7 and 8, which is drained. Evolution evidences the persistence of eosinophilia and positive Arc-2 is obtained for Fasciola. She was administered Triclabendazol and is currently asymptomatic.


CONCLUSIONS
The invasive stage of human fascioliasis may cause hepatic hematoma as a rare complication. The triad of persisting eosinophilia, painful hepatomegalia and prolonged fever leads to insist in the search of fascioliasis in endemic areas.
Loja Oropeza
David
D
Departamento de Medicina Interna, Hospital Nacional Arzobispo Loayza, Lima- Perú.
Alvizuri Escobedo
José
J
Vilca Vásquez
Maricela
M
Avilés Gonzaga
Roberto
R
Sánchez Mercado
Mario
M
D000328:Adult; D004802:Eosinophilia / Q000209:etiology; D005211:Fascioliasis / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005334:Fever / Q000209:etiology; D006406:Hematoma / Q000209:etiology*; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D008107:Liver Diseases / Q000209:etiology*