Koledokta Tıkanma Oluşturan Bir Distomiasis Olgusu

Öz

13 yaşındakı kız çocukta sağ üst kadranda ağrı, ateş ve titreme şikayetleri mevcuttu. Evalüasyonunda,endoskopik retrograd kolanjiopankreatografi ERCP uygulandı. Alınan safra örneğinin mikroskopik incelenmesindeyumurtalar saptandı. İndirekt hemaglütinasyon tekniği ile Fasciola hepatica’ya spesifik antikor için serolojik testpozitif 1/820 titrede bulundu. Kesin tanı operasyonda konuldu. Koledokotomi uygulandı ve etken kanaliçerisinden çıkarıldı. Eozinofil sayısı operasyon sonrasında da 12 ay süreyle yüksek seyretti. Takibinde tam iyileşmesaptandı

Anahtar Kelimeler

• Fasciola hepatica, koledok tıkanması, kurt

A Case Of Distomiasis With The Choledochal Obstruction

Abstract

A 13 year-old girl suffered from right upper quadrant pain, and fever with chills. In evaluation of the case, theendoscopic retrograde cholangiopancreatography ERCP was performed, and eggs of worm were observedmicroscopically in biliary specimen. The serologic test for Fasciola-specific antibody by IHA indirect haemagglutination was positive at 1/820 titer. Definite diagnosis was established intraoperatively. At surgery choledochotomywith extirpation of the flukes from the biliary drainage was performed without any complications. Eosinophiliapersisted 12 months after the operation. In the post-operative follow-up, a complete cure was observed

Keywords

• Fasciola hepatica, choledochal obstruction, fluke

References

1. 1. Sexton JL, Miner AR, Campbell NJ. Fasciola hepatica: immunoprecipitation analysis of biosynthetically labelled antigen using sera from infected sheep. Parasite Immunol 1991;13:105-108.
2. 2. Froyd G. Liver fluke in Great Britain: a survey of affected livers. Vet Rec 1975; 97:492-495.
3. 3. Chen MG, Mott KE. Progress in assessment of morbidity due to Fasciola hepatica infection. A review of recent literature. Trop Dis Bull 1990; 8:2-38.
4. 4. Levine DM, Hillyer GV, Flores SI. Comparison of counterelectrophoresis, the enzyme-linked immunosorbent assay and kato faecal examination for the diagnosis of distomiasis in infected mice and rabbits. Am J Trop Med Hyg 1980; 29:602-608.
5. 5. Guobadia EE, Fagbemi BO. Time-course analysis of antibody response in EITB and ELISA before and after chemotherapy in sheep infected with F. gigantica. Vet Parasitol 1995; 58:247-253.
6. 6. Farrel CJ, Shen DT, Wescott RB, Lang BZ. An enzyme-linked immunosorbent assay for diagnosis of Fasciola hepatica infection in cattle. Am J Vet Res 1981; 42(2):237-240.
7. 7. Pfister K, Daveau CH, Ambroise-Thomas P. Partial purification of somatic and excretory- secretory products of adult Fasciola hepatica and their application for the serodiagnosis of experimental and natural distomiasis using an ELISA. Res in Vet Sci 1984; 37: 39-43.
8. 8. Leclipteux TH, Torgerson PR, Doherty ML, McCole D, Protz M, Farnir F, Losson B. Use of excretory-secretory antigens in a competition test to follow the kinetics of infection by Fasciola hepatica in cattle. Vet Parasitol 1988; 77:103-114.

9. 9. Korkmaz M. Fasciolosis: Dünü, Bugünü, Yarını. 11. Ulusal Parasitoloji Kongresi, 6-10 Eylül. 1999, Sivas. T. Parazitol. Dern. Bildiri Özetleri. 1-8.
10. 10. Hassan MM, Moustafa NE, Mahmout LA, Abbaza BE, Hegab MH. Prevalence of Fasciola enfection among school children in Sharkia Governorate, Egypt. J Egypt Soc Parasitol 1995; 25(2): 543-549.
11. 11. Han JK, Chol BI, Cho JM, Chung KB, Han MC, Kim C-W. Radiological findings of human fasciolosis. Abdom Imaging 1993; 18:261–264.
12. 12. Espino, A.M., Finlay, C.M. Sandwich enzyme-linked immunosorbent assay for detection of excretory secretory antigens in humans with fascioliasis. J Clin Microbiol 1994; 32:190-193.
13. 13. Youssef FG, Mansour NS, Azis AE. Early diagnosis of human fascioliasis by the detection of coproantigens using counterimmunoelectrophoresis. Trans R Soc Trop Med Hyg 1991; 85:383-384.
14. 14. Langley RJ, Hillyer GV. Detection of circulating parasite antigen in murine fascioliasis by two-site enzyme-linked immunosorbent assay. Am J Trop Med Hyg 1989; 41:472-478.
15. 15. Espino AM, Díaz A, Pérez A, Finlay CM. Dynamics of antigenemia and coproantigens during a human Fasciola hepatica outbreak. J Clin Microbiol 1998; 36: 2723-2726.
16. 16. Gilbert DN, Moellering RC, Sande MA. The Sanford Guide to Antimicrobial Therapy. 2000, 93.
17. 17. Demir A, Cümşüdov C, Topgül K, ve ark. Koledokta Fasciola hepatica. Gastroenterol 1996; 7 (1 Ek): 90.
18. 18. Atalay F, Kirimlioglu V, Dagli U, Akincioglu T, Akoglu M, Seven C. Human fascioliasis. Surg Today 1993; 23(4):366-9.
19. 19. Tetik A, Türkkan I, Bilgen K, Yandakçı K. Mekanik iktere neden olan beş Fasciola hepatica vakası. Klinik ve Deneysel Cerr Derg 1995; 3 (4): 229.
20. 20. Kayabali I, Gokcora IH, Yerdel MA, Ormeci N. Hepatic fascioliasis and biliary surgery. Int Surg 1992; 77 (3): 154-7.