2026 Volume 68 Issue 7 Pages 1311-1316
An 82-year-old man with recurrent cholangitis was admitted to our hospital. Contrast-enhanced CT MRI, and abdominal ultrasonography revealed thickening of the bile duct wall without evidence of malignant or tumorous lesions. IDUS revealed a concentric, uniformly thick, and highly echoic structure in the bile duct lumen. Cytology and biopsy revealed no malignant findings. Suspecting a parasitic cause, extraction was attempted using a retrieval balloon, successfully removing a live fluke, measuring 23mm, was brown, and had a leaf-like morphology. Parasitological identification and serological testing confirmed Fasciola hepatica. This case is valuable because the parasitic organism was successfully removed via endoscopic transpapillary extraction. This case highlights the renewed importance of IDUS for endoscopic evaluation. This study will contribute to future clinical practice and raise awareness regarding fascioliasis as a differential diagnosis for similar cases.
