Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Corresponding author:
Jae Bock Chung,
ABSTRACT
The liver fluke, Clonorchis sinensis is a food-borne trematode, which chronically infects the bile ducts, and more rarely, the pancreatic duct and gall-bladder of human-beings and other mammals. The general pathologic features of infection with Clonorchis sinensis are characterized by edema, desquamation and acute inflammatory cellular response in the bile ducts in the early stage, and by goblet-cell hyperplasia, adenomatous hyperplasia and wall thickening in the chronic stage. Radiologic examinations usually reveal dilated peripheral intrahepatic bile ducts and normal extrahepatic bile ducts. Innumerable oval, round, linear or rice-like filling defects of adult flukes in medium-sized and small bile ducts may be seen on cholangiography, but complete obstruction of the bile ducts is a rare event. Herein we experienced a case of clonorchiasis which presented unusual manifestation of obstructive jaundice. Endoscopic retrograde cholangiography showed total occlusion at the level of common hepatic duct, which mimics extrahepatic bile duct carcinoma. For its unusual manifestation, we report this case with review of literatures.
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