Bleeding ulcer in the common bile duct due to Fasciola hepatica

Fatal complications caused by Fasciola hepatica are very rare. We describe the case of a 5-yr-old girl who died of a rare complication of fascioliasis--ulceration of the common bile duct by the parasite, which provoked acute hematobilia. This is the first report of a case in which fascioliasis was presented clinically as upper gastrointestinal bleeding. Normally, this parasite hatches in the duodenum, pierces the intestinal wall, and enters in the liver where it finally reaches the bile ducts. In this case the parasite probably entered the papilla of Vater and continued into the common bile duct where it attempted to perforate the wall of the duct, repeating the normal process used to perforate the wall of the duodenum.