Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 28, 2011; 17(44): 4899-4904
Published online Nov 28, 2011. doi: 10.3748/wjg.v17.i44.4899
Clinical presentation and management of Fasciola hepatica infection: Single-center experience
Muhsin Kaya, Remzi Beştaş, Sedat Çetin
Muhsin Kaya, Remzi Beştaş, Department of Gastroenterology, Dicle University School of Medicine, Diyarbakır 21280, Turkey
Sedat Çetin, Department of Internal Medicine, Dicle University School of Medicine, Diyarbakır 21280, Turkey
Author contributions: Kaya M designed the study, wrote the manuscript, performed all endoscopic retrograde cholangiopancreatography procedures and collected data; Beştaş R and Çetin S collected data.
Correspondence to: Muhsin Kaya, MD, Department of Gastroenterology, Dicle University, School of Medicine, Diyarbakır 21280, Turkey.
Telephone: +90-532-3479458 Fax: +90-532-3479458
Received: April 8, 2011
Revised: June 15, 2011
Accepted: June 22, 2011
Published online: November 28, 2011

AIM: 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.

CONCLUSION: Fasciola hepatica infection should be considered in the differential diagnosis of patients with hepatic or biliary disease and/or acute pancreatitis associated with eosinophilia.

Keywords: Fasciola hepatica, Liver abscesses, Cholangitis, Pancreatitis, Triclabendazole