A rare condition as a cause of mass lesion in the liver: Fasciola hepatica
Turkish Journal of Gastroenterology, cilt.12, sa.2, ss.145-148, 2001 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 12 Sayı: 2
- Basım Tarihi: 2001
- Dergi Adı: Turkish Journal of Gastroenterology
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.145-148
- Anahtar Kelimeler: Fasciola hepatica, Liver, Zoonosis
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
A 25-year old female was evaluated for dyspepsia and abdominal pain. The pain was progressive, radiating backwards, and was not related to food consumption. She also reported a seven-day period of jaundice several days prior to referral. The upper abdomen was tender on physical examination. Laboratory tests revealed elevated ESR (45mm/h), GGT (11 U/L) and ALP (300U/L), while blood smear revealed eosinophilia (15%). On abdominal ultrasound, a mass lesion in the liver was found. Further evaluation with CT revealed an irregular, four cm lesion in the posterior segment of the right lobe of the liver, near to the right kidney. The intrahepatic bile canaliculi and ductus choledochus appeared normal at ERCP. Microscopic evaluation of the bile revealed larvae of Fasciola hepatica and the patient was diagnosed with fasciolosis. Fasciola hepatica is a bile duct fluke. Humans with fasciolosis generally have a history of watercress or potentially contaminated water consumption. The disease is prevalent in developing countries with humid climates and large agricultural populations. However, analysis of Turkish medical literature demonstrated few case reports about human fasciolosis. As the prevalence is lower than expected, one may assume that sub-clinical cases might be underdiagnosed. The patient was treated with a single dose of oral triclobendazole (10 mg/kg). At three-month follow up, her symptoms had improved and the lesion had become smaller in CT. This patient is unique among the published cases in Turkey, as no operative procedure was performed as treatment. Long-term follow up is ongoing.