2025 Volume 39 Issue 4 Pages 676-683
A 70-year-old man presented with epigastric pain. Abdominal ultrasonography revealed a dilated bile duct, and blood tests showed elevated levels of hepatobiliary enzymes. Computed tomography indicated an irregular hypoechoic area measuring 34mm at the pancreatic head.
The distal bile duct exhibited localized stenosis and wall thickening. Endoscopic ultrasound showed an indistinct area in the pancreatic head. Endoscopic retrograde cholangiopancreatography revealed localized stenosis of the bile duct in the pancreatic head, with Giardia trophozoites detected in both bile duct and pancreatic juice samples. The patient was treated with an oral anthelmintic drug. EUS-guided fine needle aspiration was used to confirm pancreatic head adenocarcinoma. The association between Giardia infection and malignancy is not well understood. This report discusses a case of Giardia infection incidentally discovered during the examination of a patient presenting with obstructive jaundice.
Several references were used to support our discussion.
