Clinical Features:
Most pathologic manifestations result from inflammation and intermittent obstruction of the biliary ducts.  In the acute phase, abdominal pain, nausea, diarrhea, and eosinophilia can occur.  In long-standing infections, cholangitis, cholelithiasis, pancreatitis, and cholangiocarcinoma can develop, which may be fatal.

Laboratory Diagnosis:
Microscopic demonstration of eggs in the stool or in duodenal aspirate is the most practical diagnostic method.  The adult fluke can also be recovered at surgery.

Diagnostic findings

• Microscopy
• Morphologic comparison with other intestinal parasites.

Treatment:
Praziquantel or albendazole* are the drugs of choice.  See recommendations in The Medical Letter for complete information.

* This drug is approved by the FDA, but considered investigational for this purpose.