[Clinical considerations on 2 cases of hepatic fascioliasis. Importance of the imaging examinations].

Two cases of hepatic human fascioliasis, both with antecedents of eating watercress, hepatobiliary symptoms and high eosinophilia are described. In the first one (42 year-old male), at the beginning the abdominal ecotomographical and computed tomography images suggested an hepatic tumor, but afterwards, the finding of Fasciola hepatica ova in feces and the observation of numerous typical images of the fluke in the choledochus by means of an endoscopic cholangiography, plus lesions related to a Löffler syndrome detected in a chest radiography, lead to the diagnosis of hepatic fascioliasis. The patient was treated with dehydroemetine. In the second case (52 year-old male), presented pain in the upper right abdominal quadrant; in an abdominal ecography three cystic lesions in the right liver lobe were found. Nor in the feces neither in the bile F. hepatica eggs were observed. Serological tests for fascioliasis and hydatidosis resulted positive. The endoscopic cholangiography was normal. With the presumptive diagnosis of fascioliasis the patient was treated with dehydroemetine. But as his disturbances remained during the following six months, and raising the possibility of a suppurated hydatid cyst or hepatic abscesses, he was submitted to surgery, finding F. hepatica eggs in the chocolate-like hematic liquid. In the wall and in a liver mass resected a grunuloma with eggs of the parasite was detected. The patient was treated again and cured with dehydroemetine. The existence of subcapsular hematomata and granulomas in hepatic fascioliasis, which can give raise to a diagnosis confusion due to their aspect in the ecotomography and computed tomography are commented. The cholangiographic aspect of the affection is discussed.