Lema Girma Deshimo, Mulatu Seife Feleke, Yferu Zena Admasu, Aydagnuhm Getachew Bizuneh, Gebresillassie Wogderes Bogale, Denberu Yidersal Demsie, Dagnaw Asrat Berihun, Yesuf Ermias Fikru, Gebeyaw Enguday Demeke
School of Medicine, Asrat Woldeyes Health Science Campus Debre Berhan University Debre Berhan Ethiopia.
School of Public Health, Asrat Woldeyes Health Science Campus Debre Berhan University Debre Berhan Ethiopia.
Clin Case Rep. 2025 Jul 21;13(7):e70647. doi: 10.1002/ccr3.70647. eCollection 2025 Jul.
Hepatic fascioliasis is a trematode flatworm infection caused by or . Its association with venous thrombosis is exceedingly rare and can lead to significant morbidity when complicated by such conditions. Here, we report a rare case of hepatic fascioliasis complicated by multisite venous thromboembolism (VTE), highlighting the potential link between parasitic infections and coagulopathy. A 41-year-old woman presented with right leg swelling of 3 days duration. Examination revealed hypoxemia, tachypnea, and unilateral leg swelling. Laboratory tests showed marked eosinophilia, while imaging revealed multiple hypovascular focal hepatic lesions suggestive of , alongside acute thrombosis of the right branch of the portal vein, iliac and femoral veins, and bilateral pulmonary emboli. Stool examinations were negative, but IgG serology was elevated. The patient later developed right upper quadrant pain and a drop in hematocrit; repeat imaging showed sub-capsular and parenchymal hepatic hematomas, likely related to parasite-induced liver damage and anticoagulation. She was managed with antiparasitic therapy, anticoagulation, blood transfusion, and supportive care, with good recovery. This case underscores the need to consider fascioliasis in patients from endemic regions presenting with unexplained eosinophilia and venous thrombosis. It illustrates a rare but serious complication and highlights the importance of early diagnosis, integrated management, and further research into parasite-associated coagulopathy.
肝片吸虫病是由肝片吸虫或巨片吸虫引起的吸虫类扁虫感染。它与静脉血栓形成的关联极为罕见，当合并此类情况时可导致严重的发病情况。在此，我们报告一例罕见的肝片吸虫病合并多部位静脉血栓栓塞（VTE）的病例，突出了寄生虫感染与凝血病之间的潜在联系。一名41岁女性出现右腿肿胀3天。检查发现低氧血症、呼吸急促和单侧腿部肿胀。实验室检查显示明显的嗜酸性粒细胞增多，而影像学检查发现多个肝脏低血运局灶性病变提示肝片吸虫病，同时伴有门静脉右支、髂静脉和股静脉急性血栓形成以及双侧肺栓塞。粪便检查为阴性，但肝片吸虫IgG血清学检测升高。患者后来出现右上腹疼痛和血细胞比容下降；重复影像学检查显示肝包膜下和实质内血肿，可能与寄生虫引起的肝损伤和抗凝有关。她接受了抗寄生虫治疗、抗凝、输血和支持治疗，恢复良好。该病例强调，对于来自流行地区出现不明原因嗜酸性粒细胞增多和静脉血栓形成的患者，需要考虑肝片吸虫病。它说明了一种罕见但严重的并发症，并突出了早期诊断、综合管理以及对寄生虫相关凝血病进行进一步研究的重要性。
