Abstract
Introduction: Liver Fasciola hepatica (FH) infestation is a zoonotic disorder caused by a kind of leaf-like worm. Case Report: In this article the reported patient is a woman who is 54 years old. She had been suffering from stomachaches after every meal from two years ago. Computed tomography (CT), ultrasonography (US) and magnetic resonance retrograde cholangiography (MRCP), proved that right lobe ducts are dilated although there was not any filling defects in the common bile duct (CBD). These findings were most similar with the manifestations of localized segmental cholangiocellular carcinoma (CCC) or granulomatous hepatitis but at the work up, F. hepatica infection was confirmed. The mentioned disease was diagnosed by means of imaging modalities, laboratory analysis including serology and stool examination and was cured by triclabendazole. Conclusion: Humans are infected by consuming undercooked vegetables, with the adult worms inhabiting and laying metacercariae in the biliary system. These organisms induce a chronic inflammatory state in the proximal biliary tree, presumably leading to malignant transformation of the lining epithelium.
Highlights
Liver Fasciola hepatica (FH) infestation is a zoonotic disorder caused by a kind of leaf-like worm
Hepatic granulomas can be seen in a variety of states
Hepatic granulomas may be the early finding to an underlying generalized disease
Summary
Liver Fasciola hepatica (FH) infestation is a zoonotic disorder caused by a kind of leaf-like worm. Adult worms can cause obstruction of the biliary tracts, with thickening, dilatation, and fibrosis of the segmental bile ducts.[3] The degree of hepatic destruction is consistent with the number of flukes. The chronic stage usually starts almost a few months after infestation and can be found many years later.[4] At this period patient has usually no signs and symptoms, 176 JARCM/ Summer 2016; Vol 4, No 3 epigastric and right subcostal area discomfort, loose stool, nausea, vomiting, weight loss, hepatomegaly, and icterus can persist.
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