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Case Report
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Korean J Med. 2015;88(2):187-191. Published online February 1, 2015.
DOI: https://doi.org/10.3904/kjm.2015.88.2.187
- 총 간관 종양으로 오인된 간질 1예
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박수영, 최정식, 오태선, 강혜림, 정재현, 김영구, 김종윤
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인제대학교 의과대학 부산백병원 소화기내과
- A Case of Biliary Fascioliasis Mimicking Neoplasia of the Common Hepatic Duct
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Su-Young Park, Jung-Sik Choi, Tae-Seon Oh, Hye-Rim Kang, Jae-Hyun Jung, Young-Gu Kim, Jong-Yoon Kim
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Division of Gastroenterology, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
- Corresponding author: Jung-Sik Choi ,Tel: +82-51-890-6270, Fax: +82-51-892-0273, Email: cwj1225@naver.com
- Received: April 29, 2014; Revised: June 13, 2014 Accepted: August 12, 2014.
- 저자들은 간헐적인 우상복부 동통을 보이는 39세 탈북 여성에서 총 간관 종양의 감별이 필요하여 시행한 ERCP에서 총 간관 내 간질증을 확진하고 기생충을 제거한 후 triclabendazole로 치료한 경험을 하였기에 이를 문헌고찰과 함께 보고한다.
߽ɾ :간질증; 총 간관 종양; 내시경 역행 담췌관 조영술
- Abstract
- Fascioliasis is a rare zoonotic disease caused by Fasciola hepatica, the liver fluke. Humans can become accidental hosts of this parasite by ingesting contaminated drinking water or plants containing viable metacercariae. There are two disease stages: the hepatic (acute) and biliary (chronic) stages. The biliary stage of this zoonotic infection is often misdiagnosed because the symptoms are subclinical, with intermittent cholangitis as the only sign. Endoscopic retrograde cholangiopancreatography (ERCP) has been described in the diagnosis of a few cases of fascioliasis. We used this modality to diagnose biliary fascioliasis in a 39-year-old woman with chronic hepatitis B who had intermittent abdominal pain for three years with irregular wall thickening and luminal narrowing of the common hepatic duct (CHD), which resembled neoplasia of the CHD. Following the correct diagnosis, the adult worm was removed using endoluminal forceps via endoscopic sphincterotomy. This case report confirms the diagnostic and therapeutic value of ERCP in patients with biliary fascioliasis that may mimic neoplasia of the CHD.
Keywords :Fascioliasis, Common hepatic duct, Endoscopic retrograde cholangiopancreatography
