Liver fluke disease
Introduction
Introduction to liver fluke Liver flukes are also known as Clonorchis sinensis, and their adults are parasitic in human liver and bile ducts, which can cause liver fluke. Clinically, it is characterized by anorexia, diarrhea, upper abdominal discomfort, hepatomegaly, and eosinophilia. The disease is mainly prevalent in Southeast Asian countries, and the disease is prevalent in 23 provinces, municipalities and autonomous regions. Guangdong, Taiwan and other provinces are the main epidemic areas. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of transmission: parasitic spread Complications: pancreatitis
Cause
Causes of liver fluke
Parasitic infections (40%):
Adults with liver fluke are mainly parasitic in the hepatobiliary ducts of humans or mammals (such as cats, dogs, pigs, and rats). In endemic areas, people or animals with this disease, eggs often enter the intestine with bile, mixed with feces and excreted. The eggs are swallowed into the digestive tract by the first intermediate host snail or marsh in the water, and the mites are formed by a series of development and reproduction of the scorpion and thunder. The mature tail scorpion escapes from the screw tail and swims in the water. When it encounters the second intermediate host freshwater fish or shrimp, it invades the body and forms cystic sputum, which is infectious.
Prevention
Hepatic disease prevention
1. Strengthen the hygiene publicity and hygiene supervision of the catering industry staff, and not sell uncooked fish and shrimp and contaminated meat.
2. Do a good job in manure management. The manure of cats, dogs, pigs, etc. should be strengthened to prevent the manure that has not been harmlessly treated from entering the fish pond, and it should not be stored in a place where there may be contact with food. At the same time, it is necessary to prevent pollution of water sources.
3. Manage cats, dogs, pigs and other insect-preserving hosts to reduce their transmission opportunities, which is one of the important measures to prevent the epidemic.
Complication
Hepatic complication Complications pancreatitis
Will be complicated by the following diseases: bile duct obstruction (with fatigue, weight loss, jaundice, low fever, loss of appetite, may be gallbladder tumor bile duct obstruction with right upper quadrant cramps (and radiation to the shoulders and back), nausea and vomiting (added after eating), oil Etc., more common in gallstones, of course, the cause of bile duct obstruction may also be liver or pancreatic disease, bile retention, pancreatitis.
Symptom
Symptoms of liver flukes Common symptoms Weak dyspepsia
The clinical symptoms of patients with this disease vary depending on the infection. Infected patients can be asymptomatic. When a large number of residents in non-endemic areas are infected for the first time, the human body reaction is often very significant. Patients may have fever, fatigue, jaundice, pain in the liver area, and the liver is swollen and tender. Chronic multiple infections in residents of epidemic areas may include symptoms such as loss of appetite, indigestion, abdominal pain, diarrhea, fatigue, malnutrition, jaundice, and enlarged liver. A small number of long-term repeated severe infections can eventually develop into biliary cirrhosis, which can cause biliary colic and obstructive jaundice when the adult migrates to the common bile duct.
Examine
Examination of liver fluke
Pathogen examination: blood eosinophilia. The eggs were found in the stool or duodenal drainage fluid. The positive rate of adult antigen for intradermal test, indirect red blood cell agglutination test and enzyme-linked immunosorbent assay was higher. The detection of eggs is the main basis for the diagnosis. Because the eggs are small, the direct smear method is easy to miss the test. Therefore, the egg collection method (such as water washing centrifugal sedimentation method, diethyl ether precipitation method, etc.) and duodenal drainage bile are used for centrifugal sedimentation examination. The egg is similar to the Alisoma species and is difficult to identify.
B-ultrasound imaging: the liver does not enlarge, it can be seen that the echoes around the hepatic duct and the portal brain system are only enhanced and thickened, showing a "fro" or "caterpillar"-like echo. Invasion of liver parenchyma.
Diagnosis
Diagnosis and identification of liver fluke
Living or traveling in an epidemic area, eating raw fish or shrimp and uncooked fish (including dried fish, kippers), when there are dyspepsia such as bloating, diarrhea, with hepatomegaly or other hepatobiliary diseases At that time, the possibility of the disease should be considered. The diagnosis depends on direct smear or concentrated method to find eggs. If the stool is negative for many times, it can be used for duodenal drainage, collecting bile to find eggs. Immunological examinations, such as intradermal tests, convective immunoelectrophoresis, etc., can aid in diagnosis.
