Fasciola Hepatica Case with Hemobilia

Abstract

Fasciola hepatica (FH) can lead to important hepatobiliary diseases. Here we present a case of hemobilia associated with biliary FH, which is quite a rare case. The 41–year-old patient, who underwent common bile duct exploration due to hemobilia, was found to have arterial bleeding associated with ulcer caused by a dead parasite in the common bile duct. Hemobilia is a very rare complication associated with FH. When searching for the cause of hemobilia, FH should be considered.

Hepatobiliary fascioliasis; imaging characteristics with a new finding

“…A similar mechanism may affect intrahepatic bile ducts, and we thought that intrahepatic bile duct dilation and hyperdensity on CT seen in one of our cases were compatible with local obstruction and acute hematoma. Hemobilia associated with biliary fascioliasis has been reported (13), but, to the best of our knowledge, our case (patient 2) is the first reported CT demonstration of hyperdense material compatible with acute hematoma in the intrahepatic bile duct.…”

“…Rarely a large cavitary lesion can be seen and may be as a result of reinvasion of the hepatic parenchyma by an adult worm and rupture of the bile duct (10). As a rare complication of fascioliasis, acute hemobilia related to the bleeding ulcer in the common bile duct may be seen (13,14). A similar mechanism may affect intrahepatic bile ducts, and we thought that intrahepatic bile duct dilation and hyperdensity on CT seen in one of our cases were compatible with local obstruction and acute hematoma.…”

“…The US, CT, and MRI findings of fascioliasis have been described and classified (3,12,13). The most common imaging findings of fascioliasis are multiple small nodular and branching linear lesions-frequently in the subcapsular areas of the liver parenchyma-that appear hypoechoic on US, hypodense on CT, and T1 hypointense and T2 hyperintense on MRI (4).…”

An Update on the Pathogenesis of Fascioliasis: What Do We Know?

“…Although, the incidence of acute blood loss caused by Fasciola in humans is not known, haemobilia, upper gastrointestinal bleeding, liver subcapsular hematomas, and hemoperitoneum cases have been described with acute and chronic infections. 76,[111][112][113][114][115][116] Acute blood loss is not the only mechanism associated with iron deficiency anemia in fascioliasis. Ulceration of the biliary tree mucosa, blood loss, and haemobilia have been reported in animals.…”

Tumor-like Parasitic Lesions of the Hepatobiliary Tract: Liver Flukes and Other Trematodes

“…F. hepatica can localize to the lumen of the common bile duct (Kim et al 2006) and may cause common bile duct obstruction (Dobrucali et al 2004;Gulsen et al 2006;Caprino et al 2007), sometimes mimicking cholangiocarcinoma (Yalay et al 2012). Biliary fascioliasis rarely causes hemobilia (Wong et al 1985;Bahcecioglu et al 2007). This complication may be due to bleeding bile duct ulcers induced by the parasite (Acuna-Soto and Braun-Roth 1987).…”