Largerial Disease Liver Disease, Liver Pressure, Brief Pain

Parasitical Worms.com Salad (raw vegetables) is a daily dish of many people. That is the biggest cause of liver fluke infection of aquatic vegetables (aquatic vegetables). When people eat vegetables that have not been washed out, they can get fasciolosis when they accidentally eat the tail larvae of big liver fluke.
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. The cycle of development of large liver fluke
Flukes of large liver size 30 x 10-12mm. In humans, flukes are parasitic in the liver and bile, in case of abnormalities, the parasite may be parasitized in muscles, under the skin, etc. Adult flukes lay their eggs in the bile ducts down the intestines and outward as feces Eggs with large liver fluke size 140 x 80µm The egg enters the water, hatches the hairy larvae and parasites in the snail, develops into tail larvae, the tail larvae leave the snail and attach to aquatic vegetables that create cysts or swim freely in the water. People or cattle who ingest aquatic plants or drink water with larvae will become infected with large fluke.



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Antibodies appear in the blood 2 weeks after the infection, the presence of antibodies in the blood is the basis of immune reactions that help diagnose the disease. The major liver fluke antibodies during this period are mainly IgG.
2. The stage of penetration into liver parenchyma
Flukes of the liver are mainly parasitic in liver tissue, but during the infiltration stage, the flukes may migrate and cause damage to other organs such as intestinal wall, stomach wall, abdominal wall, sometimes in match.
Pictures of large liver fluke
3 The stage of infiltrating biliary tract
After the period of invasion of liver parenchyma from 2-3 months, tapeworm invades adult bile ducts and lays eggs Here adult flukes can parasitize and cause disease for many years (possibly up to 10 years) if not detected and treated.
- At the bile ducts: flukes cause biliary tract epithelium, biliary obstruction, inflammation and secondary biliary fibrosis, which can cause biliary carcinoma.
- Acute pancreatitis.
- As a factor causing multiple infections.



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4. Symptoms
The clinical manifestations of fascioliasis are usually nonspecific, depending on the stage of development and the location of the parasite, as well as the number of larvae that enter the body.
4.1 clinical
a) Systemic symptoms:
- Fatigue, anorexia, thinning.
- Fever: Uncommon fever, high fever, chills or fever that is transient and then resolves on its own, sometimes with prolonged fever.
- Anemia: bluish skin, pale mucous membranes in cases of prolonged infection, especially in children.
b) Gastrointestinal symptoms: are the most common symptoms.
- Abdominal pain: pain in the lower right flank spread to the back or epigastric region - nose. The nonspecific pain nature, which can be dull, sometimes severe, can also cause no abdominal pain.



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- Patients with feeling of bloating, indigestion, digestive disorders, nausea.
- Some patients have clinical manifestations of a number of complications: biliary obstruction, cholangitis, acute pancreatitis, gastrointestinal bleeding ..
- Clinical examination:
+ Liver is large or normal, soft density, painful pressure, signs of interstitial press.
+ There may be fluid in the abdomen, sometimes with peritonitis.
c) Other symptoms (rare):
- Inflammatory reaction: arthralgia, myalgia, redness of the skin.
- Cough, shortness of breath or an allergic skin rash (manifested by parasitic infection).
- Pleural effusion
- Symptoms that indicate organizational damage in ectopic parasites such as breast joints, or other organs.
4.



2. Subclinical:
a) Complete blood count test: peripheral blood count may be increased or normal but the proportion of eosinophils increases.
b) Diagnostic imaging: ultrasound shows images of liver damage that is mixed honeycomb or can show images of fluid under the liver. In some cases, a computerized tomography of the liver may be necessary (these images are only suggestions).
c) Detecting antibodies against large liver fluke (mainly by ELISA technique).
d) Stool test:
- Finding eggs of big liver fluke in stool or bile fluid (however, the rate of detection of eggs is very low and depends on the testing method). Stool test for 3 consecutive days.
- Pay attention to distinguish the large liver fluke eggs from the large intestinal flukes
5. Diagnosis
5.



.1. Implementing the quadrants
- Epidemiological factors: patients living in areas of fascioliasis are endemic
- Clinical: there is one or more clinical signs mentioned above.
- Subclinical:
The proportion of eosinophils increased to over 8% (possibly up to 80%)
Diagnostic imaging for suspected cases of liver abscess: ultrasound or computerized tomography (CT-Scan) of the abdominal cavity showing the liver with mixed honeycomb shaped sounds or images of liver thickness corresponding to taste lesions or images of fluid under the liver.
Immunological diagnosis: ELISA detected serum antibodies against large liver fluke (according to manufacturer's instructions).
Stool examination or bile fluid found eggs of large liver fluke.
52 Differential diagnosis
- Liver abscess due to other parasites (amoeba, roundworm, Toxocara ...) or by bacteria (biliary abscess .



...).
- Liver cancer (liver tumor)
6. Treatment
6.1. Specific treatment
The drug of choice for specific treatment of Egaten large liver fluke is available at the "Parasitic Clinic". Patients should not arbitrarily buy drugs outside.

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