Endoscopic management of biliary fasciolosis

Fasciola hepatica Türkiye de endemik bir parazittir. Yaprak solucanlar ailesinden olan bu parazitgenellikle keçi, koyun, sığır gibi evcil hayvanlarda görülür. İnsan da ise sporadiktir. Biliyerfasciola hepatica nadir bir durumdur. Hepatik ve biliyer evrelere sahiptir. Akut fasyoliyazdasemptomlar ateş, sağ üst kadran ağrısı, eozinofili, ve hepatomegalidir. Enfeksiyonun kronikevresinde parazit yıllarca asemptomatik kalabilir. Bu makalede, şiddetli karın ağrısı atakları,bulantı ve kusma şikayetleri ile hastanemize başvurup, endoskopik retrogradkolanjiopankreatografi tetkiki ile tesadüfen biliyer fasyoliyaz tanısı alan bir olgu sunulmuştur.

Biliyer fasyoliyazin endoskopik tedavisi

Fasciola hepatica is an endemic parasite in Turkey that belongs to the flatworm family. Thisparasite is seen commonly among domestic animals (such as goats, sheep, and cattle) and issporadic in human. Biliary fascioliasis is a rare condition. It has a hepatic and a biliary stage.Symptoms during the acute phase include fever, right upper quadrant pain, eosinophilia, andhepatomegaly. The parasite may remain asymptomatic for many years in chronic stage of theinfection. Here we present a case of biliary fascioliasis who was admitted to the hospital withepisodes of severe abdominal pain, nausea and vomiting and was accidentally diagnosed byendoscopic retrograde cholangiopancreatography.

PDF

___

1. Mahmoud AAF. Trematodes (Schistosomiasis) and other flukes. In: Mandell GL, Bennett JE, Dolin R eds. Mandell, Douglas, Bennetts Principles and practice of infectious diseases, 5th ed. New York: Churchill Livingstone, 2000; 2950-5.
2. Harinasuta T, Pungpak S, Keystone JS. Trematode infections. Opisthorchiasis, clonorchiasis, fascioliasis, and paragonimiasis. Infect Dis Clin North Am 1993; 7: 699-716.
3. Graham CS, Brodie SB, Weller PF. Imported Fasciola hepatica infection in the United States and treatment with triclabendazole. Dis Clin Infect 2001; 33: 1-5.
4. El-Newihi HM, Waked IA, Mihas AA. Biliary complications of Fasciola hepatica: the role of endoscopic retrograde cholangiography in management. J Clin Gastroenterol 1995; 21: 309-11.
5. Reddy DN, Sriram PV, Rao GV. Endoscopic diagnosis and management of tropical parasitic infestations. Gastrointest Endosc Clin N Am 2003; 13: 765-73.
6. Price TA, Tuazon CU, Simon GL. Fascioliasis: case reports and review. Clin Infect Dis 1993; 17: 426-30.
7. Carpenter HA. Bacterial and parasitic cholangitis. Mayo Clin Proc 1998; 73: 473- 8.
8. Ozer B, Serin E, Gümürdülü Y, Gür G, Yilmaz U, Boyacioğlu S. Endoscopic extraction of living fasciola hepatica: case report and literature review. Turk J Gastroenterol 2003; 14: 74-7.
9. Echenique-Elizondo M, Amondarain J, Lirón de Robles C. Fascioliasis: an exceptional cause of acute pancreatitis. JOP 2005; 6: 36-9.
10. Carnevale S, Rodríguez MI, Santillán G, Labbé JH, Cabrera MG, Bellegarde EJ, Velásquez JN, Trgovcic JE, Guarnera EA. Immunodiagnosis of human fascioliasis by an enzyme-linked immunosorbent assay (ELISA) and a micro- ELISA. Clin Diagn Lab Immunol 2001; 8: 174-7.
11. Adachi S, Kotani K, Shimizu T, Tanaka K, Shimizu T, Okada K. Asymptomatic fascioliasis. Intern Med 2005; 44: 1013-5.
12. Gulsen MT, Savas MC, Koruk M, Kadayifci A, Demirci F. Fascioliasis: a report of five cases presenting with common bile duct obstruction. Neth J Med 2006; 64: 17-9.
13. Arjona R, Riancho JA, Aguado JM, Salesa R, González-Macías J. Fascioliasis in developed countries: a review of classic and aberrant forms of the disease. Medicine (Baltimore) 1995; 74: 13-23.
14. Farag HF, Salem A, el-Hifni SA, Kandil M. Bithionol (Bitin) treatment in established fascioliasis in Egyptians. J Trop Med Hyg 1988; 91: 240-4.
15. Loutan L, Bouvier M, Rojanawisut B, Stalder H, Rouan MC, Buescher G, Poltera AA. Single treatment of invasive fascioliasis with triclabendazole. Lancet 1989; 2: 383.
16. Nik-Akhtar B, Tabibi V. Metronidazole in fascioliasis: report of four cases. J Trop Med Hyg 1977; 80: 179-80.
17. Chen MG, Mott KE. Progress in assesment of morbidity due to Fasciola hepatica infection: a review of recent literature. Trop Dis Bull 1990; 87: R1-R38.
18. Eckhardt T, Heckers H. Treatment of human fascioliasis with niclofolan. Gastroenterology 1981; 81: 795-8.