Cherdron A, Fiegel P
Deutsche Klinik für Diagnostik, Wiesbaden.
Dtsch Med Wochenschr. 1992 Feb 28;117(9):328-31. doi: 10.1055/s-2008-1062315.
For several weeks a 58-year-old woman had suffered from intermittent right upper abdominal and flank pain, loss of appetite, weight loss (2 kg in 8 weeks), as well as constipation. She had a mild eosinophilia of 0.48/nl, while the blood picture and differential count were normal. There was no evidence of cholestasis, liver disease or an inflammatory process. Upper abdominal ultrasound examination demonstrated a gall-bladder polyp with cholelithiasis and sludge. Although the intrahepatic biliary tract was normal, the gallbladder was much enlarged and contracted only moderately after a test meal. A parasitological disease was included in the differential diagnosis because the patient had lived in Tomsk, Siberia, until the previous year. Examination of faeces and duodenal secretion discovered eggs of Opisthorchis felineus, a liver fluke especially common in Siberia and the Ukraine. It was successfully treated by a single-day administration of praziquantel, 3 times 25 mg/kg after meals. A week later the patient was symptom-free and no eggs were found in the stool.
几周以来，一名58岁女性一直遭受右上腹和胁腹间歇性疼痛、食欲不振、体重减轻（8周内减轻2公斤）以及便秘的困扰。她有轻度嗜酸性粒细胞增多，嗜酸性粒细胞计数为0.48/nl，而血常规和分类计数正常。没有胆汁淤积、肝脏疾病或炎症过程的证据。上腹部超声检查显示胆囊息肉伴胆结石和胆泥。尽管肝内胆管正常，但胆囊明显增大，试餐后仅适度收缩。鉴别诊断考虑寄生虫病，因为该患者直到前一年一直生活在西伯利亚的托木斯克。粪便和十二指肠分泌物检查发现了猫后睾吸虫卵，这种肝吸虫在西伯利亚和乌克兰尤为常见。通过餐后单次服用吡喹酮成功治疗，剂量为3次，每次25mg/kg。一周后患者症状消失，粪便中未发现虫卵。
