DISCUSSION
C. sinensis is most often reported in east Asian countries,
including China, Korea, Japan and Vietnam, with approximately 35 million
infected individuals[8]. Some studies have
estimated that 12.49 million people have been infected with C.
sinensis in China[9]. C. sinensis is
mainly transmitted to humans from ingestion of freshwater
fish[1]. However, our patient had no history of
eating raw freshwater fish. Because of the nonspecific and atypical
symptoms, C. sinensis infection has always been under-recognized,
and often leads to clonorchiasis[10]. This patient
had common bile duct stones with acute cholangitis and gallbladder
stones with acute cholecystitis. Intraoperative exploration of the
common bile duct revealed C. sinensis . It is not easy to diagnoseC. sinensis infection before surgery. The preoperative MRCP
examination of this patient showed no dilation of the common bile duct.
Lack of clarity in the lower common bile duct was unlike the dilation
caused by conventional common bile duct
stones[11]. Based on that, the possibility of bile
duct parasites should be considered by radiologists and surgeons.
After surgery, the patient was treated with routine anti-infective
agents and administered hepatoprotective and choleretic drugs, and
praziquantel[12]. The T-tube did not drain theC. sinensis body, and deworming treatment was given. After
treatment, liver function improved significantly. Coexisting gallbladder
stones, common bile duct stones, and C. sinensis is relatively
rare. Previous studies and case reports[5,9,11]suggest that C. sinensis might cause gallbladder stones by
weakening the function of the gallbladder and causing the precipitation
of bilirubinate, calcium carbonate crystals, and mucin on C.
sinensis eggs. It is possible that the common bile duct stone and gall
bladder stones in our patient were caused by the C .sinensis infection.