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[Massive hepatobiliary fascioliasis].

S Sánchez-Sosa1, S Rojas-Ortega, G Reed-San Roman

  • 1Servicio de Cirugía, Hospital ISSSTEP. sergisanchez@compuserve.com

Revista De Gastroenterologia De Mexico
|July 24, 2001
PubMed
Summary
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Massive hepatobiliary fascioliasis, a rare human parasitic liver disease, was observed in two patients with alcohol-related liver disease who consumed contaminated watercress. Diagnosis and treatment are crucial for patient outcomes.

Area of Science:

  • Hepatology
  • Parasitology
  • Gastroenterology

Background:

  • Liver fascioliasis is a prevalent parasitic biliary tract disease in Mexico, with massive infestations rare in humans.
  • This report details two additional cases of massive hepatobiliary fascioliasis, a condition rarely documented in human subjects.
  • Massive hepatobiliary fascioliasis is frequently misdiagnosed as cholelithiasis, highlighting the need for increased clinical suspicion.

Observation:

  • Two patients with alcohol-related liver disease presented with symptoms including upper abdominal pain and obstructive jaundice.
  • Both patients reported consuming watercress (Nasturtium officinalis), a potential source of Fasciola hepatica infection.
  • Clinical manifestations included choledochal dilatation, with diagnosis confirmed by surgical exploration and adult fluke identification.

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Findings:

  • One patient succumbed to progressive liver failure, underscoring the severity of massive hepatobiliary fascioliasis.
  • The second patient survived and responded to praziquantel treatment, indicating a potential therapeutic option.
  • A history of watercress ingestion was a common factor in these cases and in previously reported instances.

Implications:

  • Early diagnosis and prompt treatment are vital for improving outcomes in massive hepatobiliary fascioliasis.
  • Increased awareness among clinicians regarding watercress-associated fascioliasis is necessary to prevent misdiagnosis.
  • This study contributes to the understanding of massive hepatobiliary fascioliasis, particularly in regions where it is endemic.