Sammanfattning
BACKGROUND We present a patient from South-East Asia who has been living in Norway for five years. He was referred to our department
with jaundice caused by opisthorchiasis/clonorchiasis. This reason for jaundice is highly unusual in Europe. Worldwide, however about 35 000 000
people are infected.
CASE PRESENTATION A male in his thirties, originally from South-East Asia, experienced diffuse itching for five weeks and painless jaundice for
two weeks. Blood samples showed increasing cholestasis. Abdominal ultrasound, MRCP and computed tomography showed no sign of bile duct
obstruction or liver tumour. Serological tests and liver biopsy revealed no infectious or autoimmune liver disease. ERCP showed normal bile ducts,
but large quantities of typical hookworms in the duodenum. Stool samples showed at least one egg typical of Opisthorchis/Clonorchis and a large
quantity of hookworm eggs. We interpreted these findings as parasite-induced obstruction of some of the small bile ducts. The patient recovered
completely after treatment with Praziquantel.
INTERPRETATION Jaundice due to bile duct obstruction by opisthorchiasis/clonorchiasis is a well-known problem in South-East Asia. It may
become more common in Europe as well as a result of increasing migration. Treatment with Praziquantel is simple and effective.