Clinical presentations of Fasciola Hepatica in Sulaymaniyah teaching hospitals/Iraq

Document Type : Research Paper


1 Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan region/Iraq

2 Department of Surgery, Teaching hospital, Sulaimani, Ministry of Health, Kurdistan region/Iraq


Background and objective: Fascioliasis is an often-neglected zoonotic disease caused by liver fluke Fasciola hepatica and Fasciolagigantica.Human is an accidental final host by ingestion of contaminated plants and water by metacircaria. It occurs worldwide with a high incidence in the Middle East, North Africa and South America and currently is an emerging infection in Iraq. We believe fascioliasis in Sulaymaniyah governorate is an underestimated, not well studied health problem that must be taken into consideration as an emerging infestation in our locality. To identify the characteristic clinical presentations, laboratory and radiological findings and response to treatment in patients with fascioliasis in our locality
Methods:: A retrospective case series, including all cases of Fasciola hepatica admitted to Sulaymaniyah teaching hospital in Kurdistan region of Iraq between January 2019 and January 2020. Inclusion criteria were any case of fascioliasis diagnosed by ELISA and radiological findings. The data were taken from the medical records and direct interview with the patients.
Results:The case series included 15 patients (12 females and 3 males), the mean age was 40.2 years (range, 25–54 years). Thirteen patients(86.67%) had history of watercress ingestion. Abdominal pain was the main symptom present in all fifteen (100%) and right upper abdomi­nal tenderness was the most prominent sign present in ten patients (66.67%).The two prominent laboratory abnormalities were positive enzyme linked immunosorbent assay (ELISA) in all (100%) and eosinophilia in thirteen patients (86.67%). The most abnormal CT findingswas livers multiple nodular micro-abscesses like lesions in seven(46.67%) patients. Two patients presented with biliary obstruction. Triclabendazole was given to all patients with six months follow up.
Conclusion: Fascioliasis is indeed an emerging disease in our region, it should be considered in the differential diagnosis of patients with hepatic or biliary disease with eosinophilia and history of watercress ingestion
Keywords: liver flukes in Iraq, Fasciola hepatica; Liver abscesses;diagnosis of humanfascioliasis.