HEPATIC SUBCAPSULAR HEMATOMA BY
FASCIOLASIS
*David Loja Oropeza, **José Alvizuri Escobedo, ***Maricela Vilca Vásquez,
*Roberto Avilés Gonzaga **Mario Sánchez Mercado.
SUMMARY
The case of a 22 year old woman from Huaraz is presented herein. She suffered from pain at
right hypocondrium, associated to nausea and vomits, which intensified three days prior to
admission. Upon examining her, a faded gallbladder murmur was found on the base of the
right hemithorax. There is pain in the abdomen when touched at the epigastrium and right
hypocondrium. The liver is perceived 3 cm beneath the costal edge: White blood count with
severe eosinophilia. Mild cholestasis is observed. Abdominal scan: Heterogeneous hepatic
mass, with a 13 cm diameter in the right lobe. CAT scan: Subcapsular 14x8 cm mass.
Scintiscan: Liver with a low absorption area showing absence of perfusion to the vascular
pool. She undergoes an exploratory laparotomy and an 800 cc subcapsular hematoma is found
in segment 6, 7 and 8, which is drained. Evolution evidences the persistence of
eosinophilia and positive Arc-2 is obtained for Fasciola. She was administered
Triclabendazol and is currently asymptomatic.
Conclusion: The invasive stage of human fascioliasis may cause hepatic hematoma as a rare
complication. The triad of persisting eosinophilia, painful hepatomegalia and prolonged
fever leads to insist in the search of fascioliasis in endemic areas.
KEY WORDS: Fascioliasis, hepatic hematoma, hypereosinophilia, Arc-2, Abdominal
CAT scan.
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