Liver fluke-induced choledocholithiasis with biliary ductal obstruction

Area of Science:

• Hepatology
• Parasitology
• Medical Imaging

Background:

• Liver fluke infections are uncommon in the United States.
• Biliary disease secondary to liver flukes is a rare clinical presentation.

Observation:

• A case of biliary obstruction in a Burmese immigrant is presented.
• Imaging studies including CT, ultrasound, MRI, and fluoroscopy revealed severe biliary dilatation.
• Large obstructing stones were the cause of the biliary dilatation.

Findings:

• The obstructing stones were surgically extracted.
• Analysis of the stones identified the causative parasite as a liver fluke.
• This confirmed a rare case of liver fluke-induced biliary obstruction.

Implications:

• Highlights the importance of considering parasitic infections in biliary disease, even in non-endemic regions.
• Demonstrates the utility of advanced imaging modalities in diagnosing complex biliary obstruction.
• Underscores the need for thorough stone analysis to identify rare etiologies.