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DOI:10.2214/AJR.06.1172
AJR 2007; 188:1596-1603
© American Roentgen Ray Society

Pictorial Essay

Parasitic Diseases of the Biliary Tract

Jae Hoon Lim1, So Yeon Kim2 and Cheol Min Park3

1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-230, South Korea.
2 Department of Radiology, Asan Medical Center, Seoul, South Korea.
3 Department of Radiology, Guro Hospital, Korea University, Seoul, South Korea.

OBJECTIVE. Parasites residing in the biliary tree include Clonorchis sinensis, Opisthorchis viverrini, Opisthorchis felineus, and Fasciola hepatica. They are willowy, leaf-like, flat flukes dwelling in the bile ducts and gallbladder. Human ascarides, Ascaris lumbricoides, dwelling in the small intestine, inadvertently migrate into the bile ducts and cause biliary obstruction. The purpose of this article is to illustrate typical imaging findings of liver fluke infection and biliary ascariasis.

CONCLUSION. Adult flukes of Clonorchis and Opisthorchis measure 8–15 mm and adult flukes of Fasciola measure 20–40 mm in length. The presence of flukes in the bile ducts causes dilatation of the bile ducts, varying degrees of chronic inflammation followed by adenomatous hyperplasia, and bile duct wall thickening. Imaging findings of clonorchiasis and opisthorchiasis include visualization of adult flukes in the bile ducts and gallbladder, diffuse dilatation of the peripheral small intrahepatic bile ducts with no or minimal dilatation of the large bile ducts, and thickening of the bile duct wall. In biliary fascioliasis and ascariasis, adult worms are visualized in the dilated bile ducts and gallbladder.

Keywords: biliary system • CT • infectious diseases • MRI • sonography


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