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Biliary fascioliasis: Management in a child using endoscopic retrograde cholangio pancreatography

Sandesh V Parelkar1, Sanjay N Oak, Amit Maydeo

  • 1Department of Pediatric Surgery, Seth G. S. Medical College and KEM Hospital, Mumbai, India.

Journal of Indian Association of Pediatric Surgeons
|April 20, 2013
PubMed

Insights

A pediatric case of liver fluke (Fasciola hepatica) infection caused abdominal pain and fever. Successful endoscopic removal of worms from the bile duct resolved the cholangitis and abscesses.

Area of Science:

  • Hepatology
  • Parasitology
  • Pediatric Gastroenterology

Background:

  • Fasciola hepatica infection, or fascioliasis, is a neglected tropical disease caused by liver flukes.
  • Biliary obstruction and secondary bacterial cholangitis are severe complications of hepatic fascioliasis.

Observation:

  • A 9-year-old boy presented with acute right upper quadrant abdominal pain and fever.
  • Radiologic imaging demonstrated multiple intrahepatic abscesses, cholangitis, and visualized worms within the common bile duct.

Findings:

  • Endoscopic retrograde cholangiopancreatography (ERCP) revealed Fasciola hepatica worms obstructing the common bile duct.
  • The patient underwent ERCP with sphincterotomy, followed by mechanical extraction of the worms using a basket and balloon catheter.

Implications:

  • This case highlights the utility of ERCP in diagnosing and managing biliary fascioliasis in children.
  • Timely endoscopic intervention can effectively treat complications like cholangitis and abscesses, preventing potential long-term liver damage.

Keywords:
Abdominal painFasciola hepaticaendoscopic retrograde cholangio pancreatography

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