Fascioliasis is a common parasitic disease in cattle and sheep that is
caused by the fasciola hepatica worm. Humans are sporadically infecte
d by eating cyst-laden waterplants or drinking contaminated water. We
reviewed the US and endoscopic retrograde cholangiopancreatography (ER
CP) findings of 3 patients with proven biliary fascioliasis. All patie
nts had atypical symptoms, complaining of intermittent pain in the rig
ht upper quadrant (RUQ). The US findings were mural thickening and dil
atation of the common bile duct, and echogenic material in both gallbl
adder and common bile duct. The abnormalities were present for several
months, and in some cases for years. The findings were confirmed by E
RCP. If a patient shows the described US features in combination with
atypical RUQ symptoms biliary fascioliasis should be considered.