Biliary fascioliasis: US and endoscopic retrograde cholangiopancreatography findings

Fascioliasis is a common parasitic disease in cattle and sheep that is caused by the fasciola hepatica worm. Humans are sporadically infected by eating cyst-laden waterplants or drinking contaminated water. We reviewed the US and endoscopic retrograde cholangiopancreatography (ERCP) findings of 3 patients with proven biliary fascioliasis. All patients had atypical symptoms, complaining of intermittent pain in the right upper quadrant (RUQ). The US findings were mural thickening and dilatation of the common bile duct, and echogenic material in both gallbladder and common bile duct. The abnormalities were present for several months, and in some cases for years. The findings were confirmed by ERCP. If a patient shows the described US features in combination with atypical RUQ symptoms biliary fascioliasis should be considered.