A 77-year old man living in Kyunggi-Do, Korea was surgically treated at Seoul National University Hospital on April 1981, because of acute abdomen. At laparotomy, a 1.77m long adult Taenia saginata was found both in gallbladder and in common bile duct to cause acute gangrenous cholecystitis. The relevant literature were reviewed and possible mechanisms of the disease were discussed.
parasitology-helminth-cestoda ; Taenia saginata-taeniasis ; case report ; gallbladder ; common bile duct ; acute abdomen ; laparatomy

We describe the imaging features of two cases of biliary ascariasis. Ultrasonography and CT showed no specific abnormal findings, but MR cholangiography clearly demonstrated an intraductal linear filling defect that led to the correct diagnosis. MR cholangiography is thus a useful technique for the diagnosis of biliary ascariasis.
Adult ; Animal ; Ascariasis/*diagnosis ; *Ascaris lumbricoides ; *Bile Ducts, Intrahepatic ; Biliary Tract Diseases/*diagnosis/*parasitology ; Common Bile Duct Diseases/*diagnosis/*parasitology ; Female ; Human ; *Magnetic Resonance Imaging

Fascioliasis is a zoonotic infection caused by Fasciola hepatica or Fasciola gigantica. We report an 87-year-old Korean male patient with postprandial abdominal pain and discomfort due to F. hepatica infection who was diagnosed and managed by endoscopic retrograde cholangiopancreatography (ERCP) with extraction of 2 worms. At his first visit to the hospital, a gallbladder stone was suspected. CT and magnetic retrograde cholangiopancreatography (MRCP) showed an intraductal mass in the common bile duct (CBD) without proximal duct dilatation. Based on radiological findings, the presumed diagnosis was intraductal cholangiocarcinoma. However, in ERCP which was performed for biliary decompression and tissue diagnosis, movable materials were detected in the CBD. Using a basket, 2 living leaf-like parasites were removed. The worms were morphologically compatible with F. hepatica. To rule out the possibility of the worms to be another morphologically close species, in particular F. gigantica, 1 specimen was processed for genetic analysis of its ITS-1 region. The results showed that the present worms were genetically identical (100%) with F. hepatica but different from F. gigantica.
Aged, 80 and over ; Animals ; Base Sequence ; Cholangiocarcinoma/diagnosis ; Cholangiopancreatography, Magnetic Resonance ; Common Bile Duct/*pathology ; DNA, Helminth/*genetics ; DNA, Intergenic/genetics ; Diagnosis, Differential ; Fasciola hepatica/*genetics ; Fascioliasis/*diagnosis/parasitology ; Humans ; Male ; Neglected Diseases/diagnosis/parasitology ; Republic of Korea ; Sequence Analysis, DNA

We attempted to identify parasite DNA in the biliary stones of humans via PCR and DNA sequencing. Genomic DNA was isolated from each of 15 common bile duct (CBD) stones and 5 gallbladder (GB) stones. The patients who had the CBD stones suffered from cholangitis, and the patients with GB stones showed acute cholecystitis, respectively. The 28S and 18S rDNA genes were amplified successfully from 3 and/or 1 common bile duct stone samples, and then cloned and sequenced. The 28S and 18S rDNA sequences were highly conserved among isolates. Identity of the obtained 28S D1 rDNA with that of Clonorchis sinensis was higher than 97.6%, and identity of the 18S rDNA with that of other Ascarididae was 97.9%. Almost no intra-specific variations were detected in the 28S and 18S rDNA with the exception of a few nucleotide variations, i.e., substitution and deletion. These findings suggest that C. sinensis and Ascaris lumbricoides may be related with the biliary stone formation and development.
Aged ; Aged, 80 and over ; Animals ; Ascaridida/genetics/isolation & purification ; Ascaris lumbricoides/genetics/isolation & purification ; Base Sequence ; Clonorchis sinensis/genetics/isolation & purification ; Common Bile Duct/*parasitology ; DNA, Helminth/*genetics ; DNA, Ribosomal/genetics ; Face/parasitology ; Female ; Gallbladder/parasitology ; Gallstones/*parasitology ; Helminths/genetics/*isolation & purification ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Polymerase Chain Reaction/*methods ; RNA, Ribosomal, 18S/genetics ; RNA, Ribosomal, 28S/genetics ; Sequence Alignment