A Case of Clonorchiasis with Focal Intrahepatic Duct Dilatation Mimicking an Intrahepatic Cholangiocarcinoma

Abstract

Biliary strictures can be caused by various diseases. Intrahepatic duct (IHD) strictures are usually related to IHD stones and cholangitis. However, focal IHD strictures without IHD stones often create diagnostic problems. Parasitic diseases such as clonorchiasis can be a rare cause of an IHD stricture. Human clonorchiasis (Clonorchis sinensis infection) is an endemic parasitic disease in Eastern Asia, including Korea, and patients acquire the infestation by eating raw fish. On radiological examinations, clonorchiasis shows typically diffuse, minimal, or mild dilatation of the small IHD, particularly in the periphery, without dilatation of the extrahepatic duct. However, diagnosis of clonorchiasis can sometimes be difficult when radiological changes are atypical. We report a case of focal left IHD dilatation caused by clonorchiasis that was confused with a malignancy.

Klatskin-Like Lesions

“…Rarely, focal duct strictures of the major hepatic ducts resembling a cholangiocarcinoma may be caused by Clonorchis infestation [84]. …”

“…Parasites such as ascaris and liver flukes are known to be associated with the syndrome of oriental cholangiohepatitis. Rarely, focal duct strictures of the major hepatic ducts resembling a cholangiocarcinoma may be caused by Clonorchis infestation [ 84 ].…”

Painless Jaundice Caused by <i>Clonorchis sinensis</i> Infection: A Case Report

“…In addition, non-invasive radiologic examinations, such as MRCP and CT, make remarkable contributions to diagnosis of clonorchiasis. Dilation, increased periductal echogenicity, and stricture of the intrahepatic bile ducts can be attributed to changes due to C. sinensis infection [ 5 , 12 ], but non-specific. Some of imaging findings in the present report were in line with reported presentations, without other causes of obstructive jaundice, such as stones or space-occupying lesions.…”

Microscopic identification of possible Clonorchis/Opisthorchis infection in two Ghanaian women with undiagnosed abdominal discomfort: two case reports

“…Clonorchiasis and opisthorchiasis have huge morbidity and mortality implications for the world populace. They pose a significant threat to human health since they infect key organs such as the liver and biliary system [ 18 ]. Although most people with the infection are asymptomatic, about 5% to 10% of people with heavy fluke infections may exhibit nonspecific symptoms such as right upper quadrant abdominal pain, flatulence, and fatigue [ 1 , 3 , 4 , 10 , 19 ].…”