Endoscopic extraction of living fasciola hepatica: case report and literature review.

Fasciola hepatica infestation is known to cause bile duct inflammation and biliary obstruction. Endoscopic retrograde cholangiopancreatography shows distinct features in some patients with fascioliasis, but the condition may be overlooked in chronic cases. The endoscopic retrograde cholangiopancreatograpy images must be carefully examined to rule out other possible causes of irregularity and thickening of the common bile duct wall. Parasite removal during endoscopic retrograde cholangiopancreatograpy is one therapeutic option in patients with acute obstructive cholangitis due to F. hepatica. We present a case of fascioliasis-induced acute cholangitis that was diagnosed and treated via endoscopy. A review of the literature on extraction of living parasites is also included.