| Four patients who had obstructing carcinoma of the cystic duct and who presented themselves with enlarged and palpable gall bladders but without jaundice are reported. All patients came from endemic areas of opisthorchiasis and had evidence of opisthorchis infection by peritoneoscopic and surgical findings. All but one had opisthorchis eggs in the stool. The pathogenesis and management was discussed. ( info) |
2/8. A case of opisthorchis felineus infestation in a pilot from greece. We describe the case of a 28-year-old man from greece with Opistorchis felineus infestation. The patient presented with intense abdominal pain, bilious emesis and eosinophilia. He probably acquired the infection overseas, since he was a commercial airline pilot who used to fly to endemic areas and to consume raw or undercooked fish. He was successfully treated with praziquantel administered in divided doses over a single day. opisthorchiasis is common to eastern europe and areas of the former Soviet Union, but extremely rare in greece. Medical personnel should be cognizant of this parasitic infection, since world travel can spread it to areas of the world unaccustomed to it. ( info) |
| Liver fluke infection caused by Opisthorchiidae is a major public health problem in many parts of the far east, Southeast asia, and eastern europe. However, with the growing volume of international travel and population migration, the infection is increasingly diagnosed in countries where the disease is not endemic, particularly in north america. We report an outbreak of acute opisthorchiasis in a family that was infected in a non-disease-endemic area after eating raw carp illegally imported from a highly disease-endemic area in siberia. With the growing numbers of former Soviet Union citizens immigrating to other countries, western physicians need to be alert regarding opisthorchis-associated pathology in this population. The epidemiology and biology of Opisthorchiidae in the former Soviet Union are reviewed. ( info) |
| A case of symptomatic opisthorchiasis in a 66-year-old Laotian immigrant is presented. The diagnosis was made by transhepatic cholangiography and by finding the trematode eggs in bile fluid. The characteristic cholangiographic changes of opisthorchiasis are described, including the intraluminal filling defects, the diffuse irregular dilation of the intrahepatic bile ducts, and the abrupt endings of the terminal branches. The importance of microscopic examination of the bile is stressed especially when stool examination is negative. ( info) |
| A 60-year-old man from Eastern thailand was admitted to hospital because of right upper quadrant abdominal pain and fever. Ultrasonographic examination revealed two cavitary lesions in the right lobe of the liver. Needle aspiration obtained 110 ml of anchovy sauce-like pus which showed no bacteria on gram stain and routine culture. Serological test for E. histolytica antibody was negative. Initially, the patient responded well to metronidazole. Two weeks later, the symptoms recurred and sonography revealed one large cavitary lesion with three adjacent locules in the right lobe of the liver. Repeated needle aspiration again showed anchovy sauce-like pus which grew enterobacter agglomerans. O. viverrini ova were detected in the stool. laparotomy revealed histologically proven cholangiocarcinoma. This report indicates that O. viverrini infection associated with CCC can masquerade as liver abscess. ( info) |
| Three cases of opisthorchiasis with calculous cholecystitis was presented. The diagnosis of gallstones was made before praziquantel therapy in 2 cases, and 4 years after treatment in one case. The patients underwent cholecystectomy. Numerous O. viverrini eggs and one dead fluke were found in the bile in one case. A single stone was recovered from each gallbladder. All stones contained O. viverrini eggs. Fragments of flukes were also present in two cases. The stones consisted of a mixture of bilirubin pigment and calcium salts. ( info) |
7/8. hemobilia and liver flukes in a patient from thailand. A patient from Southeast asia presented with abdominal pain, fever, jaundice, and upper gastrointestinal bleeding of unknown origin. opisthorchis viverrini eggs were found in the stool and multiple hepatic filling defects were noted on liver scan and sonogram. Endoscopic retrograde cholangiopancreatography revealed cholelithiasis and crescent-like filling defects in the biliary system. At surgery, the gallbladder was filled with clotted blood and pigmented stones. During T-tube drainage of the common bile duct, small elliptical flukes (4 X 3 mm) identified as O. viverrini were recovered. Despite adequate biliary drainage, the patient continued to have high fevers. On the 53rd postoperative day, a larger fluke (2.8 X 0.8 cm) identified as a fasciola hepatica migrated down the T-tube. Institution of therapy with bithional resulted in complete clinical resolution within 3 wk. Six years later the patient returned with fever, jaundice, and right upper quadrant pain. Two large pigmented stones were found in the common bile duct and were removed after endoscopic sphincterotomy. The stones had developed even though there was no evidence of recurrent helminthic infection. ( info) |
| clonorchiasis and opisthorchiasis are snail-transmitted trematode infections. The disease is endemic in many parts of asia. Local case reports have been predominantly in Chinese with a history of travel to endemic countries. Thus far, 20 cases of liver fluke infestation have been reported in this country. This report presents another two cases of clonorchiasis and a case of opisthorchiasis. We also briefly review pertinent aspects of the disease. ( info) |