Fasciola hepatica: tanısında endoskopik retrograd kolanjiyopankreatografi: tek merkez deneyimi

Giriş ve Amaç: Literatürde endoskopik retrograd kolanjiyopankreatografi ile tanısı konulan Fasciola hepatica olguları daha çok vaka sunumu olarak bildirilmektedir. Çalışmamızın amacı kliniğimizde endoskopik retrograd kolanjiyopankreatografi ile tanısı konan Fasciola hepatica hastalarımızın demografik, klinik ve laboratuvar özelliklerini ortaya koymaktır. Gereç ve Yöntem: Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi endoskopik retrograd kolanjiyopankreatografi ünitesinde 2007-2016 yılları arasında endoskopik retrograd kolanjiyopankreatografi yapılan toplam 15.785 hasta retrospektif olarak tarandı. Fasciola hepatica tanısının endoskopik retrograd kolanjiyopankreatografi esnasında parazitin endoskopik görülmesi ile konulduğu 17 hasta çalışmaya alındı. Bulgular: Çalışmamıza toplam 17 hasta (15 erkek, 2 kadın) alındı. Yaş ortancası 45’di. Karın ağrısı hastaların en sık izlenen başvuru şikayetiydi. Hastalarda eozinofili görülme sıklığı %87 olarak bulundu. Endoskopik retrograd kolanjiyopankreatografi esnasında çıkarılan ortanca parazit sayısı 2’di. Sonuç: Kolestaz kliniği ile başvuran bir hastada anamnezde su teresi yeme öyküsünün olması, eozinofili varlığı, Fasciola hepatica şüphesini artıran bulgulardır. Hastaların safra yollarında birden fazla parazit olabilir; bu nedenle endoskopistin tek parazit çıktıktan sonra da dikkatli bir şekilde safra yollarını değerlendirmesi önemlidir.

Anahtar Kelimeler:

Endoskopik retrograd kolanjiyopankreatografi, Fasciola hepatica

Endoscopic retrograde cholangiopancreatography for the diagnosis of Fasciola hepatica: a single-center experience

Background and Aims: Fasciola hepatica diagnosed with endoscopic retrograde cholangiopancreatography has usually been mentioned in case reports in the literature. The aim of our study is to demonstrate the demographic, clinical, and laboratory features of Fasciola hepatica patients diagnosed with endoscopic retrograde cholangiopancreatography in our clinic. Material and Methods: A total of 15.785 patients, in whom endoscopic retrograde cholangiopancreatography was performed at Türkiye Yüksek İhtisas Training and Research Hospital in 2007-2016, were screened retrospectively. Seventeen patients diagnosed with Fasciola hepatica, which was seen through endoscopic examination, were included in the study. Results: A total of 17 patients (15 males and 2 females) were included in our study. The median age was 45. Abdominal pain was the most frequent patient complaint. The frequency of eosinophilia was 87%. The median number of parasites extracted during endoscopic retrograde cholangiopancreatography was two. Conclusion: Eating watercress and the presence of eosinophilia are findings that increase the suspicion of Fasciola hepatica in a patient admitted to hospital with cholestasis. The biliary tract of patients may have more than one parasite. Therefore, it is important for the endoscopist to evaluate the biliary tract carefully after one parasite is seen.

Keywords:

Endoscopic retrograde cholangiopancreatography,

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