Diagnosis of Fasciola Hepatica by Endoscopic Ultrasound

A 28-year-old woman was admitted for colicky abdominal pain. Mild eosinophilia (300/µl) and a slight increase in alkaline phosphatase were present. Transabdominal ultrasonography showed only mild dilation of the common bile duct. Figures [1 ] [2] show the endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) findings, respectively. Parasitology confirmed the diagnosis of Fasciola hepatica. Endoscopic ultrasound may be helpful in the diagnosis of parasites in the biliary tract.

Figure 1 Endoscopic ultrasound revealed a spiral-shaped mobile membrane (arrow) within the main bile duct (MBD). GB: gallbladder.

Figure 2 Endoscopic retrograde cholangiopancreatography showed a comma-shaped filling defect (arrows), and a live flatworm was extracted. GB: gallbladder.