Ectopic intra-abdominal fascioliasis

Human fascioliasis, caused by Fasciola hepatica, is emerging as an important chronic zoonotic disease in many areas of the world, including Turkey. It primarily involves the liver and may also cause severe damage in the tissue. Herein we report on a patient with ectopic intraabdominal fascioliasis that presented to our clinic with abdominal pain and distention. Physical and radiological examination as well as an exploratory laparotomy revealed a 10 × 10-cm mass in the splenic flexura of the colon and multiple cystic formations in the liver, spleen, and omentum, which mimicked peritoneal carcinoma. Histopathological examination revealed a granulomatous reaction due to parasites. Left hemicolectomy and partial omental resection were performed. Subsequent serological and histological examinations resulted in the diagnosis of fascioliasis. Laparotomy and treatment with triclabendazole were well tolerated by the patient. Ectopic cases of fascioliasis cannot be easily distinguished from peritoneal carcinoma involving the colon, mesocolon, and omentum, and physicians must therefore be aware of this form of infestation.