Wang Jun-Ke, Ma Wen-Jie, Lu Qiang, Zheng Er-Liang, Yang Qin, Hu Hai-Jie, Liu Fei, Li Quan-Sheng, Li Fu-Yu
Department of Biliary Surgery Department of Ultrasound Department of Gastrointestinal Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
Medicine (Baltimore). 2017 Dec;96(50):e9258. doi: 10.1097/MD.0000000000009258.
Fascioliasis is a rare cause of liver abscesses, and its clinical course consists of hepatic phase and biliary phase.
We describe a 58-year-old female patient who presented with a 2-month history of intermittent fever and abdominal pain. An abdominal computed tomography (CT) revealed confluent low-density lesions in the liver. Complete surgical resection of these abscesses was performed, and postoperative pathological examination and serological tests confirmed a diagnosis of fascioliasis. However, 4 months after the surgery, follow-up CT revealed a lesion in the retroperitoneal area. Meanwhile, ultrasonography-guided percutaneous needle biopsy of the retroperitoneal lesion was performed, and a parasitic infection was suspected.
Retroperitoneal metastasis of hepatic phase fascioliasis.
The patient received parasitic resistance treatment with triclabendazole at a dose of 10 mg/kg/d for 2 consecutive days.
After 2 courses of triclabendazole therapy, the retroperitoneal metastasis regressed to a minor lesion.
To the best of our knowledge, this is the first case report of retroperitoneal metastasis of fascioliasis, aimed at helping recognize the clinical features and treatment options of this rare disease.
肝片吸虫病是肝脓肿的罕见病因，其临床病程包括肝脏期和胆管期。
我们描述一位58岁女性患者，有2个月间歇性发热和腹痛病史。腹部计算机断层扫描（CT）显示肝脏有融合性低密度病变。对这些脓肿进行了完整的手术切除，术后病理检查和血清学检测确诊为肝片吸虫病。然而，术后4个月，随访CT显示腹膜后区域有一个病变。同时，对腹膜后病变进行了超声引导下经皮穿刺活检，怀疑为寄生虫感染。
肝脏期肝片吸虫病腹膜后转移。
患者接受了三氯苯达唑抗寄生虫治疗，剂量为10mg/kg/d，连续2天。
经过2个疗程的三氯苯达唑治疗后，腹膜后转移灶缩小为一个小病灶。
据我们所知，这是肝片吸虫病腹膜后转移的首例病例报告，旨在帮助认识这种罕见疾病的临床特征和治疗选择。
