Biliary fascioliasis mimicking sphincter of Oddi dysfunction.
Fasciola hepatica, a liver fluke of livestock, rarely presents as chronic biliary tract infection in humans. We report a 38-year-old woman from Ethiopia who presented with right upper quadrant pain and a dilated common bile duct on ultrasound and magnetic resonance cholangiopancreatography (MRCP) without other abnormalities. She was suspected to have type II sphincter of Oddi dysfunction. She underwent endoscopic retrograde cholangiopancreatography (ERCP) and had a fluke, diagnosed as Fasciola hepatica, in the common hepatic duct. This report confirms the diagnostic and therapeutic role of ERCP in the management of biliary fascioliasis, and highlights the need to include fascioliasis in the differential diagnosis of biliary pain in patients emigrating from areas where this infection is endemic.
Department of Internal Medicine, University of South Florida College of Medicine, Tampa, FL 33609, USA. jkeshish@health.usf.edu
Jonathan
J
Keshishian
Stephen G
SG
Brantley
Patrick G
PG
Brady
D000328:Adult; D000818:Animals; D000977:Antiparasitic Agents / Q000627:therapeutic use; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003937:Diagnosis, Differential; D054242:Emigrants and Immigrants; D005002:Ethiopia; D005210:Fasciola hepatica / Q000302:isolation & purification*; D005211:Fascioliasis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D006801:Humans; D009574:Nitro Compounds; D046628:Sphincter of Oddi Dysfunction / Q000000981:diagnostic imaging*; D013844:Thiazoles / Q000627:therapeutic use
D000977:Antiparasitic Agents; D009574:Nitro Compounds; D013844:Thiazoles; C041747:nitazoxanide