Liver fluke disease
Infestations of clinical importance include those by Fasciola hepatica, Clonorchis sinensis and Ascaris lumbricoides. These parasites are trematodes and undergo both sexual (definitive host) and asexual (intermediatehost) reproduction.
Fasciola hepatica
Clinical features
Patients may be asymptomatic or present with acute or chronic symptoms. Acute symptoms include a sudden onset of right upper quadrant pain, pyrexia or cholangitis and symptoms of allergic reactions. Hepatosplenomegaly may be present. Chronic symptoms include intermittent biliary colic, cholecystitis, jaundice anaemia and hypoproteinaemia.
Investigation
Full blood examination may show eosinophilia. Liver function tests show features consistent with cholestasis. Stools are examined for the presence of ova. Specific serological testing usually confirms the diagnosis.
Treatment
The condition is treated by albendazole, praziquantel or bithional. Cholecystectomy and exploration of the common bile duct by ERCP may also be necessary.