An 11-year-old girl presented with severe right upper hypochondrial
pain, fever, and severe pallor. Parasitological stool examination
using Kato-Katz technique revealed a large number of huge operculated
yellowish brown eggs. Abdominal ultrasonography revealed dilatation
of the common bile duct associated with amoving shadow. Endoscopic retrograde
cholangiopancreatographic sphincterotomy, basketing, ballooning,
and extraction of Fasciola worms from the common bile duct were done.
Key Words: pediatric, children, hypochondrial pain,
endoscopic retrograde cholangiopancreatography, Fasciola
(Infect Dis Clin Pract 2015;23: 99–101)
Fasciola hepatica is a flat, leaf-shaped trematode. Its life cycle
consists of 7 stages including egg, miracidium, sporocyst, redia,
cercaria, metacercariae, and adult fluke. The parasite has 2
hosts: intermediate and definitive hosts. Mammals such as sheep,
goats, and cattle are usually definitive hosts and infected by ingesting
metacercaria form.1 Humans contract the disease as accidental
hosts by drinking contaminated water with metacercariae;
eating watercress, lettuce, alfalfa, or spinach plants; and using
contaminated kitchenware.2 Fascioliasis has emerged as a significant
public health problem among humans in developing
countries and has been identified as one of the key neglected tropical
diseases.3,4 We report an unusual case of biliary fascioliasis
in a child. On review of literature, we found several adult
cases of biliary fascioliasis managed by endoscopy, but only 1 pediatric
case has been reported5; ours is the second case (the first
case in Egypt) managed successfully by endoscopic retrograde
cholangiopancreatography (ERCP). |
