The classic symptoms associated with clonorchis infestation are recurrent pyogenic cholangitis. There are recurrent attacks of right upper quadrant pain, jaundice and pyrexia. Examination may reveal tender hepatomegaly and splenomegaly if portal hypertension exists.
Imaging of the biliary tree by MRI or ERCP is essential to delineate the distribution of stones and strictures. Ova are demonstrated in faeces or duodenal aspirate.
The drug of choice is Praziquantel. Surgery is indicated if stones or strictures are present.