Endoscopic retrograde cholangiopancreatography for the diagnosis of Fasciola hepatica: a single-center experience
Abstract
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.
References
- 1- Lazo Molina L, Garrido Acedo R, Cárdenas Ramírez B, et al. Endoscopic removal by ERCP of Fasciola hepatica alive: two case reports and review of the literature. Rev Gastroenterol Peru 2013;33:75-81. 2- Mas-Coma S. Epidemiology of fascioliasis in human endemic areas. J Helminthol 2005;79:207-16. 3- Mas-Coma S, Valero MA, Bargues MD. Chapter 2. Fasciola, lymnaeids and human fascioliasis, with a global overview on disease transmission, epidemiology, evolutionary genetics, molecular epidemiology and control. Adv Parasitol 2009; 69:41-146. 4- Chan CW, Lam SK. Diseases caused by liver flukes and cholangiocarcinoma. Baillieres Clin Gastroenterol 1987;1:297-318. 5- Alatoom A, Cavuoti D, Southern P, et al. Fasciola hepatica Infection in the United States. Lab Med 2008;39:425-8. 6- Aksoy DY, Kerimoglu U, Oto A, et al. Fasciola hepatica infection: Clinical and computerized tomographic findings of ten patients. Turk J Gastroenterol 2006;17:40-5. 7- Mas-Coma S, Agramunt VH, Valero MA. Neurological and ocular Fascioliasis in Humans. Adv Parasitol 2014;84:27-149. 8- Kaya M, Beştaş R, Cetin S. Clinical presentation and management of Fasciola hepatica infection: singlecenter experience. World J Gastroenterol 2011;17:4899-904. 9- Sezgin O, Altıntaş E, Tombak A, et al. Fasciola hepatica induced acute pancreatitis: report of two cases and review of the literature. Turk J Gastroenterol 2010;21:183-7. 10- Ashrafi K, Bargues MD, O'Neill S, Mas-Coma S. Fascioliasis: a worldwide parasitic disease of importance in travel medicine. Travel Med Infect Dis 2014;12:636-49. 11- Ulger BV, Kapan M, Boyuk A, et al. Fasciola hepatica infection at a University Clinic in Turkey. J Infect Dev Ctries 2014;8:1451-5. 12- Van Beers B, Pringot J, Geubel A, et al. Hepatobiliary fascioliasis: noninvasive imaging findings. Radiology 1990;174:809-10. 13- Dusak A, Onur MR, Cicek M, et al. Radiological imaging features of Fasciola hepatica infection - A pictorial review. Clin Imaging Sci 2012;2:2. 14- Patel NU, Bang TJ, Dodd GD 3rd. CT findings of human Fasciola hepatica infection: case reports and review of the literature. Clin Imaging 2016;40:251-5. 15- Sezgin O, Altintaş E, Dişibeyaz S, et al. Hepatobiliary fascioliasis: clinical and radiologic features and endoscopic management. J Clin Gastroenterol 2004;38:285-91. 16- Behzad C, Lahmi F, Iranshahi M, et al. Finding of biliary fascioliasis by endoscopic ultrasonography in a patient with eosinophilic liver abscess. Case Rep Gastroenterol 2014;8:310-8. 17- Lazo Molina L, Garrido Acedo R, Cárdenas Ramírez B, et al. Endoscopic removal by ERCP of Fasciola hepatica alive: two case reports and review of the literature. Rev Gastroenterol Peru 2013;33:75-81. 18- Sayilir A, Ödemis B, Köksal AS, et al. Image of the month: Fasciola hepatica as a cause of cholangitis. Am J Gastroenterol 2012;107:655. 19- López-Vélez R, Domínguez-Castellano A, Garrón C. Successful treatment of human fascioliasis with triclabendazole. Eur J Clin Microbiol Infect Dis 1999;18:525-6.
Abstract
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.
References
- 1- Lazo Molina L, Garrido Acedo R, Cárdenas Ramírez B, et al. Endoscopic removal by ERCP of Fasciola hepatica alive: two case reports and review of the literature. Rev Gastroenterol Peru 2013;33:75-81. 2- Mas-Coma S. Epidemiology of fascioliasis in human endemic areas. J Helminthol 2005;79:207-16. 3- Mas-Coma S, Valero MA, Bargues MD. Chapter 2. Fasciola, lymnaeids and human fascioliasis, with a global overview on disease transmission, epidemiology, evolutionary genetics, molecular epidemiology and control. Adv Parasitol 2009; 69:41-146. 4- Chan CW, Lam SK. Diseases caused by liver flukes and cholangiocarcinoma. Baillieres Clin Gastroenterol 1987;1:297-318. 5- Alatoom A, Cavuoti D, Southern P, et al. Fasciola hepatica Infection in the United States. Lab Med 2008;39:425-8. 6- Aksoy DY, Kerimoglu U, Oto A, et al. Fasciola hepatica infection: Clinical and computerized tomographic findings of ten patients. Turk J Gastroenterol 2006;17:40-5. 7- Mas-Coma S, Agramunt VH, Valero MA. Neurological and ocular Fascioliasis in Humans. Adv Parasitol 2014;84:27-149. 8- Kaya M, Beştaş R, Cetin S. Clinical presentation and management of Fasciola hepatica infection: singlecenter experience. World J Gastroenterol 2011;17:4899-904. 9- Sezgin O, Altıntaş E, Tombak A, et al. Fasciola hepatica induced acute pancreatitis: report of two cases and review of the literature. Turk J Gastroenterol 2010;21:183-7. 10- Ashrafi K, Bargues MD, O'Neill S, Mas-Coma S. Fascioliasis: a worldwide parasitic disease of importance in travel medicine. Travel Med Infect Dis 2014;12:636-49. 11- Ulger BV, Kapan M, Boyuk A, et al. Fasciola hepatica infection at a University Clinic in Turkey. J Infect Dev Ctries 2014;8:1451-5. 12- Van Beers B, Pringot J, Geubel A, et al. Hepatobiliary fascioliasis: noninvasive imaging findings. Radiology 1990;174:809-10. 13- Dusak A, Onur MR, Cicek M, et al. Radiological imaging features of Fasciola hepatica infection - A pictorial review. Clin Imaging Sci 2012;2:2. 14- Patel NU, Bang TJ, Dodd GD 3rd. CT findings of human Fasciola hepatica infection: case reports and review of the literature. Clin Imaging 2016;40:251-5. 15- Sezgin O, Altintaş E, Dişibeyaz S, et al. Hepatobiliary fascioliasis: clinical and radiologic features and endoscopic management. J Clin Gastroenterol 2004;38:285-91. 16- Behzad C, Lahmi F, Iranshahi M, et al. Finding of biliary fascioliasis by endoscopic ultrasonography in a patient with eosinophilic liver abscess. Case Rep Gastroenterol 2014;8:310-8. 17- Lazo Molina L, Garrido Acedo R, Cárdenas Ramírez B, et al. Endoscopic removal by ERCP of Fasciola hepatica alive: two case reports and review of the literature. Rev Gastroenterol Peru 2013;33:75-81. 18- Sayilir A, Ödemis B, Köksal AS, et al. Image of the month: Fasciola hepatica as a cause of cholangitis. Am J Gastroenterol 2012;107:655. 19- López-Vélez R, Domínguez-Castellano A, Garrón C. Successful treatment of human fascioliasis with triclabendazole. Eur J Clin Microbiol Infect Dis 1999;18:525-6.
Details
| Journal Section | Articles |
|---|---|
| Authors | |
| Publication Date | August 31, 2016 |
| Published in Issue | Year 2016 Volume: 24 Issue: 2 |