The uninvited guest: live fasciola hepatica as a cause of obstructive jaundice-a case report.

BACKGROUND

Hepatic fascioliasis is a zoonotic infection caused by Fasciola hepatica. It is underdiagnosed due to its non-specific clinical presentation and limited diagnostic tools in many healthcare settings. Human infections, though uncommon, are rising in endemic areas.

CASE PRESENTATION: We report a 40-year-old South Asian female presenting with a 3-month history of vague right hypochondrial pain, nausea, and poor appetite. Laboratory tests showed cholestatic jaundice. Abdominal ultrasound revealed gallbladder sludge and a dilated common bile duct. ERCP was performed and revealed live Fasciola hepatica worms in the biliary tree. Post-extraction, she was treated with albendazole with complete resolution of symptoms and normalization of liver biochemistry.

CONCLUSIONS

This case highlights the importance of considering hepatic fascioliasis in patients with atypical hepatobiliary symptoms, especially in endemic regions. ERCP played a pivotal role in both diagnosis and management.