Parasites and Biliary stones

Clonorchiasis ٢٦
end is broad and has a small spine-like prominence (Dooley and Neafie,
1976).
A number of serological techniques have been developed as
supplementary diagnostic methods. The intradermal test, which uses a
diluted extract of adult C. sinensis antigens, was once used widely (Rim,
1986). but is not recommended any more because of its very low
specificity. Enzyme-linked immunosorbent assay for the detection of
antibodies against C. sinensis has also been used as an alternative
serological test (Chen et al., 1988). However, unfortunately, the
serological methods currently available exhibit considerable cross-
reactivity and therefore are not widely accepted as screening techniques
(Ambroise-Thomas and Goullier, 1984).
Imaging Findings:
Cholangiography may also show a characteristic appearance of
Clonorchis worms as filling defects within the ductal system. Depending
on the projection, one of five patterns may appear on the cholangiogram:
filamentous, wavy, curled-up, elliptical wavy and elliptical-shaped filling
defects (Leung et al., 1989).Within the peripheral intrahepatic ducts;
dilatation of the intrahepatic ducts, particularly in the periphery; and a
hazy appearance of the intrahepatic ducts (Choi, 1984 and Okuda et al.,
1973).
Filling defects are several millimeters in diameter which is
compatible with the width of the fluke. The predominant dilatation of the
peripheral ducts is related to the location of the worms. The haziness of
the intrahepatic ducts is probably caused by the increased production of
mucinous material and incomplete mixing of the contrast media (Choi
and Han, 2001).