An Illustrative Case
An example may help you understand the pathology of clonorchiasis and how it is diagosed.
A 19-year-old Korean woman who had immigrated to the United States seven months previously was admitted presenting with nausea, vomiting (clear emesis) and right upper quadrant and epigastric pain that varied between being constant and cramping.
Upon physical examination, the patient was found to have a temperature.
Some laboratory values were elevated:
White blood cell count
Serum alanine transaminase (ALT)
Total serum bilirubin
Serum alkaline phosphatase (ALP)
Serum aspartate transaminase (AST)
A soft black common bile duct stone was removed during endoscopic retrograde cholangiopancreatography, and intrahepatic ducts with areas of stricture and possible proximal dilatation were noted. Ultrasound examination revealed a dilated common bile duct and multiple, markedly dilated tubular structures in the liver. The patient was treated with praziquantel for a bile duct disorder that was probably caused by Clonorchis sinensis infection. Her gastrointestinal symptoms responded well to this treatment.