Clonorchis sinensis Liver Flukes

This image-guided case involves a 70-year-old man undergoing cholangioscopy prior to resection of sigmoid adenocarcinoma. CT had revealed choledocholithiasis and bile duct dilation. During the procedure, five live flatworms were visualized in the biliary tract; two were extracted and identified as Clonorchis sinensis, a liver fluke endemic to East Asia. The patient had no signs of cholangiosarcoma, a chronic complication. Notably, stool testing for eggs was negative; the diagnosis relied on direct visualization. Treatment included praziquantel, followed by initiation of adjuvant chemotherapy for the unrelated colon cancer. Infection likely stemmed from raw freshwater fish or shrimp consumption.

This image-guided case involves a 70-year-old man undergoing cholangioscopy prior to resection of sigmoid adenocarcinoma. CT had revealed choledocholithiasis and bile duct dilation. During the procedure, five live flatworms were visualized in the biliary tract; two were extracted and identified as Clonorchis sinensis, a liver fluke endemic to East Asia. The patient had no signs of cholangiosarcoma, a chronic complication. Notably, stool testing for eggs was negative; the diagnosis relied on direct visualization. Treatment included praziquantel, followed by initiation of adjuvant chemotherapy for the unrelated colon cancer. Infection likely stemmed from raw freshwater fish or shrimp consumption.