title: Clinical presentation and management of Fasciola hepatica infection: single-center experience.
abstract: OBJECTIVE
  To identify the characteristic clinical, laboratory and radiological findings and response to treatment in patients with fascioliasis.
  
  
  METHODS
  Patients who were diagnosed with Fasciola hepatica infection were included in this prospective study. Initial clinical, laboratory and radiological findings were recorded. All patients were followed until a complete response was achieved or for 6 mo after treatment discontinuation.
  
  
  RESULTS
  Fasciola hepatica infection was diagnosed in 30 patients (24 females; mean age: 42.6 years) between January 2008 and February 2011. Twenty-two (73%) patients had hepatic phase fascioliasis, 5 patients had biliary phase, and 3 patients had biliary phase associated with acute pancreatitis. Of the 8 patients with biliary phase fascioliasis, 2 patients displayed features that overlapped with both hepatic and biliary phase. Abdominal pain and right upper abdominal tenderness were the most prominent signs and symptoms in all patients. Eosinophilia was the most prominent laboratory abnormality in both patients with hepatic and biliary phase (100% and 50%, respectively). Multiple nodular lesions like micro-abscesses on abdominal computerized tomography were the main radiological findings in patients with hepatic phase. Small linear filling defects in the distal choledochus were the main endoscopic retrograde cholangiopancreatography (ERCP) findings in patients with biliary phase. Patients with hepatic phase were treated with triclabendazole alone, and patients with biliary phase were treated with triclabendazole and had live Fasciola hepatica extracted from the bile ducts during ERCP.
  
  
  CONCLUSIONS
  Fasciola hepatica infection should be considered in the differential diagnosis of patients with hepatic or biliary disease and/or acute pancreatitis associated with eosinophilia.
authors.affiliation: Department of Gastroenterology, Dicle University School of Medicine, Diyarbakır 21280, Turkey. muhsinkaya20@hotmail.com
authors.forename: Muhsin
authors.initials: M
authors.lastname: Kaya
authors.forename: Remzi
authors.initials: R
authors.lastname: Beştaş
authors.forename: Sedat
authors.initials: S
authors.lastname: Cetin
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000469:parasitology / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use; D001652:Bile Ducts / Q000469:parasitology / Q000473:pathology; D003937:Diagnosis, Differential; D019468:Disease Management; D005210:Fasciola hepatica; D005211:Fascioliasis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D000077682:Triclabendazole; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D001562:Benzimidazoles; D000077682:Triclabendazole