Research Center for Hydatid Disease in Iran, Dept of Surgery, Afzalipour Medical Center, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Research Center for Hydatid Disease in Iran, Dept of Parasitology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
BMC Infect Dis. 2023 May 19;23(1):336. doi: 10.1186/s12879-023-08310-z.
Fascioliasis, caused by Fasciola hepatica, is a neglected zoonotic food-borne trematodiasis. The Caspian littoral in northern Iran is endemic for the disease, and human fascioliasis is well-known in that region. In the present study, we report the diagnosis, identification, and clinical management of a human case of fascioliasis associated with common bile duct (CBD) obstruction from a non-endemic remote area in southeastern Iran.
A 42-year-old female was admitted to Afzalipour Medical Center hepatobiliary surgery ward in Kerman with abdominal pain for the past three months. Dilated biliary tract and an ill-defined mass in CBD were reported in abdominal ultrasonography and magnetic resonance cholangiopancreatography, respectively. During distal CBD operation, nine leaf-like motile flatworms were isolated. A morphological study confirmed all the isolates as Fasciola, and further molecular investigations, identified the flukes as F. hepatica using both pepck multiplex PCR and cox1 sequencing.
Molecular and morphological findings of the study indicated the presence of human fascioliasis in the southeastern province of Sistan and Baluchestan in Iran. Fascioliasis is among the etiologies of chronic cholecystitis, and physicians should consider chronic cholecystitis associated with fascioliasis in the differential diagnosis. In the present report, endoscopic ultrasound was usefully applied for the accurate diagnosis of biliary fasciolosis.
由肝片吸虫引起的片形吸虫病是一种被忽视的食源性动物源性吸虫病。伊朗北部的里海沿岸地区是该病的流行区，该地区的人类片形吸虫病广为人知。在本研究中，我们报告了一例来自伊朗东南部非流行地区的与胆总管（CBD）阻塞相关的人类片形吸虫病的诊断、鉴定和临床管理。
一名 42 岁女性因腹痛三个月入住克尔曼 Afzalipour 医疗中心肝胆外科病房。腹部超声和磁共振胰胆管成像分别报告胆管扩张和 CBD 内边界不清的肿块。在进行远端 CBD 手术时，分离出 9 个叶状可移动的扁平虫。形态学研究证实所有分离物均为片形吸虫，进一步的分子研究使用 pepck 多重 PCR 和 cox1 测序鉴定为肝片吸虫。
研究的形态学和分子结果表明，伊朗锡斯坦和俾路支省东南部存在人类片形吸虫病。片形吸虫病是慢性胆囊炎的病因之一，医生在鉴别诊断时应考虑与片形吸虫病相关的慢性胆囊炎。在本报告中，内镜超声在准确诊断胆管片形吸虫病方面具有良好的应用价值。
