Biliary Tract Obstruction Due to Fasciola hepatica Managed by ERCP

Fascioliasis is a health problem in several countries including the Islamic Republic of Iran.  In a review of the medical publications during 1990-2002, only 22 cases of biliary tract obstruction by fasciola hepatica have been reported.  Herein, we are adding a new case of fasciola hepatica causing bile duct obstruction and presenting with intermittent colicky pain, eosinophilia and bile duct dilatation.  This condition was diagnosed by endoscopic retrograde cholaogio-pancreatography (ERCP) and was treated by extemporaneous papillotomy.  This case report confirms that in endemic areas, fascioliasis should be included in the list of the differential diagnosis for colicky abdominal pain, eosinophilia and bile duct dilatation.  The condition could be concurrently diagnosed and treated by ERCP.