Fascioliasis diagnosed by EUS and ERCP

摘要

A 69-year-old asymptomatic woman was referred for evaluation of an isolated increase in alkaline phosphatase, 167 UI/L (normal <104 UI/L). In 2007, she had a laparo-scopic cholecystectomy for cholelithiasis. The laboratory tests all showed normal results, including total bilirubin, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, white blood cell count, and antimito-chondrial antibodies. The abdominal US demonstrated a 9-mm common bile duct (CBD), with no dilation of the in-trahepatic bile ducts. We decided to perform EUS to rule out an unsuspected biliary obstruction, although the diameter of the CBD could be considered normal.