Rarely, liver flukes emerge from the biliary drainage duct.

A male patient (57 years old, in Hoa Binh ) was admitted to the hospital with abdominal pain, fever, jaundice, fatigue, and dark urine. After examination and testing, the patient was diagnosed with small liver flukes .

The patient said he often ate raw fish. For about a month now, his condition has been getting worse, and despite going to many places for examination, the disease has not been detected.

Hiếm gặp, sán lá gan chui ra từ ống dẫn lưu đường mật - Ảnh 1.

The patient was admitted to the hospital with abdominal pain, fever, jaundice, and fatigue. Photo: Provided by the hospital

Associate Professor, Dr. Do Duy Cuong, Director of the Tropical Disease Center, Bach Mai Hospital, said that at the lower level, the patient had an abdominal CT scan and discovered dilated bile ducts in the liver and was diagnosed with a bile duct tumor. At Bach Mai Hospital, the patient had a bile duct drainage tube placed.

During the treatment, the doctor discovered many adult liver flukes measuring about 0.5 - 1 cm in size crawling out through the drainage tube, along with stool tests showing fluke eggs. The patient was diagnosed with a small liver fluke infection that parasitizes the liver, causing obstruction and infection of the bile duct, from which the bacteria enter the blood, causing accompanying blood infection, so it is easy to misdiagnose blood infection or bile duct cancer.

After being treated with specific medicine, the patient is now stable, alert, no longer feverish, less jaundice, less bile obstruction, and the drainage tube no longer has worms coming out.

Associate Professor Cuong said this is a rare case in Vietnam as well as in the world because diagnosing small liver flukes is often difficult, requiring the placement of a duodenal drainage tube to test for eggs. Furthermore, never before have so many adult flukes emerged from the bile ducts or small liver fluke eggs been found in the stool.

Hiếm gặp, sán lá gan chui ra từ ống dẫn lưu đường mật - Ảnh 3.

Image of liver fluke crawling out of patient's bile duct

According to Associate Professor Cuong, liver fluke disease is a common parasitic infection in Vietnam and has been on the rise recently due to the habit of eating raw fish and undercooked food, which can cause serious complications and affect human health.

Liver flukes are divided into two main types: small liver flukes and large liver flukes. People infected with small liver flukes are often due to eating fish and snails containing uncooked worm larvae or eating raw fish salad from ponds and freshwater fish. With large liver flukes, people are often infected by eating raw vegetables that grow underwater such as (coriander, watercress, water spinach, celery, etc.) that are infected with worm larvae. The disease causes abscesses in the liver and can be confused with many other liver diseases such as bacterial abscesses, liver tumors or liver cysts.

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