Hepatic fascioliasis at a London hospital--the importance of recognising typical radiological features to avoid a delay in diagnosis.

Hepatic fascioliasis is a zoonosis caused by the trematode Fasciola hepatica, which can cause hepatobiliary disease in humans via the ingestion of contaminated water or aquatic vegetables. Reported cases of human infection with F. hepatica arise in regions where cattle are raised, with particular abundance in South America and the Middle East. The typical radiological appearances associated with fascioliasis are well reported and are likely to be more easily recognisable by radiologists in these areas of high prevalence. However, in Western countries where the disease is seldom found, there may be a delay in diagnosis and treatment owing to unfamiliarity with the radiological appearances, in addition to the non-specific clinical features on presentation. Here we describe a case of a 22-year-old Bangladeshi woman whose only clinical feature was right upper quadrant pain. Abnormal imaging of her abdomen on admission began a process of investigations to seek the correct diagnosis.