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[肝片吸虫病。基于病例报告的鉴别诊断及潜伏性问题]

[Fascioliasis of the liver. Differential diagnosis and questions of latency based on a case report].

作者信息

Sigl H, Holzer E, Faupel H W

机构信息

IV. Medizinische Abteilung des Städt. Krankenhauses München-Schwabing.

出版信息

Leber Magen Darm. 1988 Aug;18(4):204-17.

PMID:3216768
Abstract

A 49-years old female patient was admitted to the hospital with abdominal pain and symptoms of a shock. Four months before she had been sick and been an outpatient with slight pain in the upper abdomen and remarkable weight loss. The suspicion of perforated gall bladder was the indication to a laparotomy. A tumor on the right lobe of the liver was found. The histological diagnosis was: eosinophilic portal hepatitis with multiple eosinophilic abscesses in the liver. The parasitologic serology showed a positive test for Fasciola (liver fluke). Praziquantel in high doses was promptly effective and cured the patient. The sheep liver fluke is a common parasite of the biliary tract of herbivores all over the world, but rarely leads to a human disease. The patient had lived many decades in the South Pacific. The differential diagnoses was manifold because of the traveling habits, the clinical symptomatic and the course of the disease. The biology of the sheep liver fluke implies an infection acquired in Europe some weeks before the first symptoms of the disease.

摘要

一名49岁女性患者因腹痛和休克症状入院。四个月前她生病,曾是门诊患者,有上腹部轻微疼痛和显著体重减轻的症状。怀疑胆囊穿孔是进行剖腹手术的指征。术中发现肝脏右叶有一个肿瘤。组织学诊断为:嗜酸性门静脉性肝炎伴肝脏多发嗜酸性脓肿。寄生虫血清学检查显示肝片吸虫(肝吸虫)检测呈阳性。高剂量吡喹酮迅速起效并治愈了该患者。羊肝吸虫是世界各地食草动物胆道的常见寄生虫,但很少导致人类疾病。该患者在南太平洋生活了几十年。由于其旅行习惯、临床症状和病程,鉴别诊断多种多样。羊肝吸虫的生物学特性表明,在疾病的最初症状出现前几周在欧洲感染。

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