Foie parasitaire

Abstract

The parasitic liver is a many-faceted entity, the study of which leads to review the whole set of nosologic settings in hepatology. The liver can be concerned by cosmopolitan or exotic parasites with highly variable incidence and prevalence, simply in transit, or as usual hosts, or trapped in the hepatic gland; the consequences range from epiphenomenona to anatomo-clinical manifestations potentially serious and life threatening. The pathophysiology results from interactions between the host, the external environment and the parasite, the aggression of which involving immunologic phenomena as well as parenchymatic or biliary mechanical constraints. Anatomoclinical groupings allow to individualize three acute clinical presentations – the immunoallergic hepatomegalia, the hepatic abscess, and the cholestatic icterus (the identification of which is facilitated by abdominal ultrasound scanning and techniques of parasitic immunology) – , three chronic settings, often more insidious, the translation of which being in any case either biological, radiological or punctuated by mechanical or even sometimes carcinological complications, and the particular context of immunodepression. The whole set of therapeutic tools consists mainly in anti-parasitic chemotherapies, among which the recent molecules represent undeniable advances, as well as in interventional endoscopy reserved for a limited number of indications.