Worms crawl out of bile duct due to eating raw vegetables

Hanoi 57-year-old male patient, often eats raw fish, recently had stomach ache, fever, jaundice, fatigue, doctor discovered many worms crawling out of the bile duct.

On August 31, Associate Professor, Dr. Do Duy Cuong, Director of the Tropical Disease Center, Bach Mai Hospital, said that the abdominal CT scan results at the lower level detected dilated bile ducts in the liver, and was diagnosed with a bile duct tumor. The patient was then transferred to Bach Mai Hospital to have a bile duct drainage tube placed.

Here, the doctor discovered many adult liver flukes measuring about 0.5-1 cm in size coming out through the drainage tube. The patient was diagnosed with small liver flukes, causing obstruction and infection of the biliary tract, and was treated with the specific anti-fluke drug Praziquantel and intravenous antibiotics. The patient is now stable, alert, no longer feverish, less jaundice, and less biliary obstruction. The drainage tube no longer has any flukes coming out and he can be discharged in the next few days.

The patient is being treated at Bach Mai Hospital. Photo: Thanh Duong — The patient is being treated at Bach Mai Hospital. Photo: *Thanh Duong*

"This is a rare case in Vietnam as well as in the world . We have never seen so many adult worms crawling out of the bile ducts as well as small liver fluke eggs found in the stool," said Dr. Cuong.

Liver fluke is a common parasitic infection in Vietnam due to the habit of eating raw fish and undercooked food. The disease is divided into two main types: small liver fluke and large liver fluke. People infected with small liver fluke are often due to eating fish and snails containing uncooked worm larvae; or eating raw fish from ponds and freshwater fish. After eating, the larvae enter the stomach, go down to the duodenum and then travel up the bile duct to the liver, causing damage to the bile duct, causing bile duct obstruction and dilation.

People infected with large liver flukes are often infected by eating raw vegetables that grow underwater (coriander, watercress, water spinach, celery, ...) infected with tapeworm larvae. The disease causes abscesses in the liver and can be confused with many other diseases such as bacterial abscesses, tumors or liver cysts.

Associate Professor Cuong recommends that people should eat cooked food and drink boiled water, and not eat uncooked fish, snails, raw vegetables, or aquatic vegetables. Wash your hands thoroughly before eating and take deworming medicine regularly. If you suspect you are infected, you must go to a medical facility for examination, testing, diagnosis, and timely treatment. In addition, doctors at the grassroots level also need to be trained, pay attention to medical history, and perform additional tests to confirm the presence of worms in order to diagnose and use medicine according to the correct regimen.

Le Nga

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