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Images in medicine
Fascioliasis: a rare cause of liver abscess
  1. Shridhar S Dronamraju1,
  2. Bryon C Jaques1,
  3. Matthias Schmid2,
  4. Julie R Samuel3,
  5. Richard M Charnley1
  1. 1Department of Hepatobiliary Pancreatic and Transplant Surgery, Freeman Hospital, Newcastle Upon Tyne, Tyne and Wear, UK
  2. 2Department of Infection and Tropical Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, Tyne and Wear, UK
  3. 3Department of Microbiology, Royal Victoria Infirmary, Newcastle Upon Tyne, Tyne and Wear, UK
  1. Correspondence to Dr Shridhar Sanjeevarao Dronamraju, Department of Hepatobiliary Pancreatic and Transplant Surgery, Freeman Hospital, Newcastle Upon Tyne, Tyne and Wear NE7 7DN, UK; shridhar.dronamraju{at}nuth.nhs.uk

http://dx.doi.org/10.1136/postgradmedj-2013-131942

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    Introduction

    Fascioliasis, a liver fluke infection caused by Fasciola hepatica, is one of the rarer causes of liver abscesses1. Differentiating these infections from the more common pyogenic and amoebic liver abscesses can be difficult. Diagnosis can be confirmed by demonstrating live parasites or eggs in the bile or feces2. We present the radiograph images and a short video which demonstrate a liver fluke being removed from the bile duct at endoscopic retrograde cholangio-pancreatography (ERCP) in a lady who presented with a liver abscess.

    The case

    A 65-year-old retired teacher presented with a 3-months’ history of upper abdominal discomfort and nausea. Over the past 2 years she had travelled …

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    Footnotes

    • Contributors SSD: collection of data, editing of images and video and preparing the manuscript. RMC: conceived the idea, performed the endoscopic procedure, recorded the video of the procedure and revision of the manuscript. MS, JRS, and BCJ helped with providing the data and revision of the manuscript.

    • Competing interests None.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.