Ann Surg Treat Res.  2014 Aug;87(2):104-107. 10.4174/astr.2014.87.2.104.

Acute cholecystitis associated with Clonorchis sinensis infection

• Oh JT
• Kang DB
• Jo HJ

• KMID: 1882839
• DOI: http://doi.org/10.4174/astr.2014.87.2.104

Abstract

Clonorchis sinensis is one of the most common causes of trematodiasis that is caused by the ingestion of raw fish contaminated with infective cysts. The adult flukes are predominantly present in the intrahepatic bile ducts, but occasionally they may be found in the pancreatic duct and extrahepatic bile ducts. The clinical manifestations depend on the number of flukes, the period of infestation, and complications such as pericholangitic abscess, cholangitis, bile duct stones, and cholangiocarcinoma. However, primary acute cholecystitis associated with C. sinensis infection is extremely rare. Herein, we report on a case of primary acute cholecystitis associated with C. sinensis infection.

Keyword

Acute cholecystitis; Clonorchis sinensis

MeSH Terms

Abscess
Adult
Bile Ducts
Bile Ducts, Extrahepatic
Bile Ducts, Intrahepatic
Cholangiocarcinoma
Cholangitis
Cholecystitis, Acute*
Clonorchis sinensis*
Eating
Humans
Pancreatic Ducts
Trematoda

Figure

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  Fig. 1 Axial unenhanced (A) and contrast-enhanced abdominal computed tomography images (B) show a distended gallbladder with wall thickening and pericholecystic fluid collection. It also shows minimal dilatation of the peripheral intrahepatic bile ducts.

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  Fig. 2 MR cholangiography shows a distended gallbladder, pericholecystic fluid collection, and mild extrahepatic bile duct dilation without obstructive lesions.

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  Fig. 3 Operative finding shows several flukes removed from the cystic duct and gallbladder.

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  Fig. 4 Operative cholangiography shows neither bile duct dilatation nor obstructive lesions.

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  Fig. 5 Histopathological examinations show a severe inflammatory mucosal change of the gallbladder (A: H&E, ×40) and ovum (B: H&E, ×200), which is confirmed by the presence of Clonorchis sinensis.

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