# Pancreatitis Manifestation and Mimicking Gallstone Symptoms Caused by Fasciola Hepatica: A Case Report

## TL;DR

A 53-year-old woman's long-term symptoms were caused by a rare liver parasite, which was successfully treated with endoscopic removal.

## Contribution

This case report highlights the importance of recognizing Fasciola hepatica as a cause of biliary symptoms and pancreatitis.

## Key findings

- Endoscopic retrograde cholangiopancreatography (ERCP) successfully extracted five live Fasciola hepatica parasites.
- Fasciola hepatica can mimic gallstone symptoms and cause pancreatitis through bile duct obstruction.

## Abstract

Fasciola hepatica is a parasitic trematode that infects humans, typically through the consumption of contaminated water or raw vegetables. The infection progresses through acute and chronic phases, with the latter often presenting as jaundice, cholangitis, pancreatitis, and cholecystitis due to bile duct obstruction. We report the case of a 53-year-old Iranian woman who experienced persistent eosinophilia, nausea, right upper quadrant and epigastric pain, and occasional chills for one year. Imaging revealed a dilated common bile duct (CBD) with sludge, and endoscopic retrograde cholangiopancreatography (ERCP) successfully identified and extracted five live Fasciola hepatica parasites. This case illustrates the vital role of early recognition and intervention in fascioliasis, as timely endoscopic management can prevent severe complications. Increased awareness among clinicians, especially in regions where the disease is uncommon, is essential to ensure prompt diagnosis and effective treatment of this often-overlooked infection.