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eFigure 18–8. Dilated bile ducts. A: CT shows a dilated distal bile duct (arrowhead). L, liver; k, kidney. B: CT demonstrates dilated intrahepatic bile ducts (arrow) and a liver mass (M). (Reproduced, with permission, from Barth KH. Percutaneous biliary drainage for high obstruction. Radiol Clin North Am. 1990;28:1226.) An axial CT scan shows an enlarged bile duct adjacent to liver and kidney. An axial CT scan shows enlarged bile ducts on either side of a liver mass.

Current Medical Diagnosis & Treatment 2025 > Jaundice & Evaluation of Abnormal Liver Biochemical Tests

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eFigure 18–8. Dilated bile ducts. A: CT shows a dilated distal bile duct (arrowhead). L, liver; k, kidney. B: CT demonstrates dilated intrahepatic bile ducts (arrow) and a liver mass (M). (Reproduced, with permission, from Barth KH. Percutaneous biliary drainage for high obstruction. Radiol Clin North Am. 1990;28:1226.) An axial CT scan shows an enlarged bile duct adjacent to liver and kidney. An axial CT scan shows enlarged bile ducts on either side of a liver mass.

Current Medical Diagnosis & Treatment 2025 > Jaundice & Evaluation of Abnormal Liver Biochemical Tests

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eFigure 18–10. Schematic diagram of a percutaneous transhepatic cholangiogram, here used to provide drainage for an obstructing pancreatic carcinoma. A: A dilated peripheral intrahepatic bile duct is entered percutaneously with a fine needle (arrow). B: A long guidewire is passed through the needle into the intrahepatic duct, common hepatic duct, and common bile duct, and then advanced past the tumor into the duodenum. C: The needle is withdrawn, and a plastic catheter has been passed over the guidewire to create a channel through the liver parenchyma. D: An external-internal drainage catheter is inserted over the guidewire and through the channel, then advanced via the bile ducts and through the tumor to empty into the duodenum. (Reproduced, with permission, from James TW, Baron TH. Endoscopic and Radiologic Treatment of Biliary Disease. In: Feldman M, Friedman LS, Brandt LJ [editors]. Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 2 vol set, 11th edition. Philadelphia, Elsevier; 2023.) Four diagrams of the liver and gall bladder depict the steps in a percutaneous transhepatic cholangiogram.

Current Medical Diagnosis & Treatment 2025 > Jaundice & Evaluation of Abnormal Liver Biochemical Tests

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eFigure 18–15. Alcohol-associated cirrhosis of the liver. A: Small regenerative nodules are separated by coarse bands of collagen in which are found blood vessels, bile ducts, and inflammatory cells. B: The regenerative nodule is composed of a disorganized mass of liver cells showing fatty change. There is no central hepatic vein in the nodule. (Reproduced, with permission, from Chandrasoma P, Taylor CR. Concise Pathology, 2nd ed. Originally published by Appleton & Lange. Copyright © 1995 by The McGraw-Hill Companies, Inc.) A histology shows groups of cells, or nodules, separated by the collagen. A histology shows a magnified view of a regenerative nodule.

Current Medical Diagnosis & Treatment 2025 > Alcohol-Associated Liver Disease

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eFigure 18–15. Alcohol-associated cirrhosis of the liver. A: Small regenerative nodules are separated by coarse bands of collagen in which are found blood vessels, bile ducts, and inflammatory cells. B: The regenerative nodule is composed of a disorganized mass of liver cells showing fatty change. There is no central hepatic vein in the nodule. (Reproduced, with permission, from Chandrasoma P, Taylor CR. Concise Pathology, 2nd ed. Originally published by Appleton & Lange. Copyright © 1995 by The McGraw-Hill Companies, Inc.) A histology shows groups of cells, or nodules, separated by the collagen. A histology shows a magnified view of a regenerative nodule.

Current Medical Diagnosis & Treatment 2025 > Alcohol-Associated Liver Disease

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eFigure 37–25. Life cycles of Fasciola hepatica and Fasciola gigantica (liver flukes). Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria, and Pseudosuccinea. In the snail, the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3–4 months. The adult flukes (F hepatica: up to 30 mm by 13 mm; F gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. F hepatica infects various animal species, mostly herbivores. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Fasciola species.

Current Medical Diagnosis & Treatment 2025 > Fascioliasis

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eFigure 37–25. Life cycles of Fasciola hepatica and Fasciola gigantica (liver flukes). Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria, and Pseudosuccinea. In the snail, the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3–4 months. The adult flukes (F hepatica: up to 30 mm by 13 mm; F gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. F hepatica infects various animal species, mostly herbivores. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Fasciola species.

Current Medical Diagnosis & Treatment 2025 > Fascioliasis

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eFigure 37–25. Life cycles of Fasciola hepatica and Fasciola gigantica (liver flukes). Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria, and Pseudosuccinea. In the snail, the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3–4 months. The adult flukes (F hepatica: up to 30 mm by 13 mm; F gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. F hepatica infects various animal species, mostly herbivores. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Fasciola species.

Current Medical Diagnosis & Treatment 2025 > Fascioliasis

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eFigure 37–25. Life cycles of Fasciola hepatica and Fasciola gigantica (liver flukes). Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria, and Pseudosuccinea. In the snail, the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3–4 months. The adult flukes (F hepatica: up to 30 mm by 13 mm; F gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. F hepatica infects various animal species, mostly herbivores. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Fasciola species.

Current Medical Diagnosis & Treatment 2025 > Fascioliasis

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eFigure 37–25. Life cycles of Fasciola hepatica and Fasciola gigantica (liver flukes). Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria, and Pseudosuccinea. In the snail, the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3–4 months. The adult flukes (F hepatica: up to 30 mm by 13 mm; F gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. F hepatica infects various animal species, mostly herbivores. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Fasciola species.

Current Medical Diagnosis & Treatment 2025 > Fascioliasis

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eFigure 37–25. Life cycles of Fasciola hepatica and Fasciola gigantica (liver flukes). Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria, and Pseudosuccinea. In the snail, the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3–4 months. The adult flukes (F hepatica: up to 30 mm by 13 mm; F gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. F hepatica infects various animal species, mostly herbivores. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Fasciola species.

Current Medical Diagnosis & Treatment 2025 > Fascioliasis

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eFigure 37–25. Life cycles of Fasciola hepatica and Fasciola gigantica (liver flukes). Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria, and Pseudosuccinea. In the snail, the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3–4 months. The adult flukes (F hepatica: up to 30 mm by 13 mm; F gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. F hepatica infects various animal species, mostly herbivores. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Fasciola species.

Current Medical Diagnosis & Treatment 2025 > Fascioliasis

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eFigure 37–25. Life cycles of Fasciola hepatica and Fasciola gigantica (liver flukes). Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria, and Pseudosuccinea. In the snail, the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3–4 months. The adult flukes (F hepatica: up to 30 mm by 13 mm; F gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. F hepatica infects various animal species, mostly herbivores. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Fasciola species.

Current Medical Diagnosis & Treatment 2025 > Fascioliasis

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eFigure 37–25. Life cycles of Fasciola hepatica and Fasciola gigantica (liver flukes). Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria, and Pseudosuccinea. In the snail, the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3–4 months. The adult flukes (F hepatica: up to 30 mm by 13 mm; F gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. F hepatica infects various animal species, mostly herbivores. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Fasciola species.

Current Medical Diagnosis & Treatment 2025 > Fascioliasis

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eFigure 37–25. Life cycles of Fasciola hepatica and Fasciola gigantica (liver flukes). Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria, and Pseudosuccinea. In the snail, the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3–4 months. The adult flukes (F hepatica: up to 30 mm by 13 mm; F gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. F hepatica infects various animal species, mostly herbivores. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Fasciola species.

Current Medical Diagnosis & Treatment 2025 > Fascioliasis

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eFigure 37–25. Life cycles of Fasciola hepatica and Fasciola gigantica (liver flukes). Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria, and Pseudosuccinea. In the snail, the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3–4 months. The adult flukes (F hepatica: up to 30 mm by 13 mm; F gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. F hepatica infects various animal species, mostly herbivores. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Fasciola species.

Current Medical Diagnosis & Treatment 2025 > Fascioliasis

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eFigure 37–25. Life cycles of Fasciola hepatica and Fasciola gigantica (liver flukes). Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria, and Pseudosuccinea. In the snail, the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3–4 months. The adult flukes (F hepatica: up to 30 mm by 13 mm; F gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. F hepatica infects various animal species, mostly herbivores. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Fasciola species.

Current Medical Diagnosis & Treatment 2025 > Fascioliasis

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eFigure 37–26. Life cycle of Clonorchis sinensis (Chinese liver fluke). Embryonated eggs are discharged in the biliary ducts and in the stool. Eggs are ingested by a suitable snail intermediate host . Each egg releases a miracidia , which go through several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and after a short period of free-swimming time in water, they come in contact and penetrate the flesh of freshwater fish, where they encyst as metacercariae . Infection of humans occurs by ingestion of undercooked, salted, pickled, or smoked freshwater fish . After ingestion, the metacercariae excyst in the duodenum and ascend the biliary tract through the ampulla of Vater . Maturation takes approximately 1 month. The adult flukes (measuring 10–25 mm by 3–5 mm) reside in small- and medium-sized biliary ducts. In addition to humans, carnivorous animals can serve as reservoir hosts. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Trematode species.

Current Medical Diagnosis & Treatment 2025 > Clonorchiasis & Opisthorchiasis

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eFigure 37–26. Life cycle of Clonorchis sinensis (Chinese liver fluke). Embryonated eggs are discharged in the biliary ducts and in the stool. Eggs are ingested by a suitable snail intermediate host . Each egg releases a miracidia , which go through several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and after a short period of free-swimming time in water, they come in contact and penetrate the flesh of freshwater fish, where they encyst as metacercariae . Infection of humans occurs by ingestion of undercooked, salted, pickled, or smoked freshwater fish . After ingestion, the metacercariae excyst in the duodenum and ascend the biliary tract through the ampulla of Vater . Maturation takes approximately 1 month. The adult flukes (measuring 10–25 mm by 3–5 mm) reside in small- and medium-sized biliary ducts. In addition to humans, carnivorous animals can serve as reservoir hosts. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Trematode species.

Current Medical Diagnosis & Treatment 2025 > Clonorchiasis & Opisthorchiasis

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eFigure 37–26. Life cycle of Clonorchis sinensis (Chinese liver fluke). Embryonated eggs are discharged in the biliary ducts and in the stool. Eggs are ingested by a suitable snail intermediate host . Each egg releases a miracidia , which go through several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and after a short period of free-swimming time in water, they come in contact and penetrate the flesh of freshwater fish, where they encyst as metacercariae . Infection of humans occurs by ingestion of undercooked, salted, pickled, or smoked freshwater fish . After ingestion, the metacercariae excyst in the duodenum and ascend the biliary tract through the ampulla of Vater . Maturation takes approximately 1 month. The adult flukes (measuring 10–25 mm by 3–5 mm) reside in small- and medium-sized biliary ducts. In addition to humans, carnivorous animals can serve as reservoir hosts. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Trematode species.

Current Medical Diagnosis & Treatment 2025 > Clonorchiasis & Opisthorchiasis

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eFigure 37–26. Life cycle of Clonorchis sinensis (Chinese liver fluke). Embryonated eggs are discharged in the biliary ducts and in the stool. Eggs are ingested by a suitable snail intermediate host . Each egg releases a miracidia , which go through several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and after a short period of free-swimming time in water, they come in contact and penetrate the flesh of freshwater fish, where they encyst as metacercariae . Infection of humans occurs by ingestion of undercooked, salted, pickled, or smoked freshwater fish . After ingestion, the metacercariae excyst in the duodenum and ascend the biliary tract through the ampulla of Vater . Maturation takes approximately 1 month. The adult flukes (measuring 10–25 mm by 3–5 mm) reside in small- and medium-sized biliary ducts. In addition to humans, carnivorous animals can serve as reservoir hosts. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Trematode species.

Current Medical Diagnosis & Treatment 2025 > Clonorchiasis & Opisthorchiasis

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eFigure 37–26. Life cycle of Clonorchis sinensis (Chinese liver fluke). Embryonated eggs are discharged in the biliary ducts and in the stool. Eggs are ingested by a suitable snail intermediate host . Each egg releases a miracidia , which go through several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and after a short period of free-swimming time in water, they come in contact and penetrate the flesh of freshwater fish, where they encyst as metacercariae . Infection of humans occurs by ingestion of undercooked, salted, pickled, or smoked freshwater fish . After ingestion, the metacercariae excyst in the duodenum and ascend the biliary tract through the ampulla of Vater . Maturation takes approximately 1 month. The adult flukes (measuring 10–25 mm by 3–5 mm) reside in small- and medium-sized biliary ducts. In addition to humans, carnivorous animals can serve as reservoir hosts. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Trematode species.

Current Medical Diagnosis & Treatment 2025 > Clonorchiasis & Opisthorchiasis

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eFigure 37–26. Life cycle of Clonorchis sinensis (Chinese liver fluke). Embryonated eggs are discharged in the biliary ducts and in the stool. Eggs are ingested by a suitable snail intermediate host . Each egg releases a miracidia , which go through several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and after a short period of free-swimming time in water, they come in contact and penetrate the flesh of freshwater fish, where they encyst as metacercariae . Infection of humans occurs by ingestion of undercooked, salted, pickled, or smoked freshwater fish . After ingestion, the metacercariae excyst in the duodenum and ascend the biliary tract through the ampulla of Vater . Maturation takes approximately 1 month. The adult flukes (measuring 10–25 mm by 3–5 mm) reside in small- and medium-sized biliary ducts. In addition to humans, carnivorous animals can serve as reservoir hosts. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Trematode species.

Current Medical Diagnosis & Treatment 2025 > Clonorchiasis & Opisthorchiasis

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eFigure 37–26. Life cycle of Clonorchis sinensis (Chinese liver fluke). Embryonated eggs are discharged in the biliary ducts and in the stool. Eggs are ingested by a suitable snail intermediate host . Each egg releases a miracidia , which go through several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and after a short period of free-swimming time in water, they come in contact and penetrate the flesh of freshwater fish, where they encyst as metacercariae . Infection of humans occurs by ingestion of undercooked, salted, pickled, or smoked freshwater fish . After ingestion, the metacercariae excyst in the duodenum and ascend the biliary tract through the ampulla of Vater . Maturation takes approximately 1 month. The adult flukes (measuring 10–25 mm by 3–5 mm) reside in small- and medium-sized biliary ducts. In addition to humans, carnivorous animals can serve as reservoir hosts. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Trematode species.

Current Medical Diagnosis & Treatment 2025 > Clonorchiasis & Opisthorchiasis

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eFigure 37–26. Life cycle of Clonorchis sinensis (Chinese liver fluke). Embryonated eggs are discharged in the biliary ducts and in the stool. Eggs are ingested by a suitable snail intermediate host . Each egg releases a miracidia , which go through several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and after a short period of free-swimming time in water, they come in contact and penetrate the flesh of freshwater fish, where they encyst as metacercariae . Infection of humans occurs by ingestion of undercooked, salted, pickled, or smoked freshwater fish . After ingestion, the metacercariae excyst in the duodenum and ascend the biliary tract through the ampulla of Vater . Maturation takes approximately 1 month. The adult flukes (measuring 10–25 mm by 3–5 mm) reside in small- and medium-sized biliary ducts. In addition to humans, carnivorous animals can serve as reservoir hosts. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Trematode species.

Current Medical Diagnosis & Treatment 2025 > Clonorchiasis & Opisthorchiasis

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eFigure 37–26. Life cycle of Clonorchis sinensis (Chinese liver fluke). Embryonated eggs are discharged in the biliary ducts and in the stool. Eggs are ingested by a suitable snail intermediate host . Each egg releases a miracidia , which go through several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and after a short period of free-swimming time in water, they come in contact and penetrate the flesh of freshwater fish, where they encyst as metacercariae . Infection of humans occurs by ingestion of undercooked, salted, pickled, or smoked freshwater fish . After ingestion, the metacercariae excyst in the duodenum and ascend the biliary tract through the ampulla of Vater . Maturation takes approximately 1 month. The adult flukes (measuring 10–25 mm by 3–5 mm) reside in small- and medium-sized biliary ducts. In addition to humans, carnivorous animals can serve as reservoir hosts. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Trematode species.

Current Medical Diagnosis & Treatment 2025 > Clonorchiasis & Opisthorchiasis

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eFigure 37–26. Life cycle of Clonorchis sinensis (Chinese liver fluke). Embryonated eggs are discharged in the biliary ducts and in the stool. Eggs are ingested by a suitable snail intermediate host . Each egg releases a miracidia , which go through several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and after a short period of free-swimming time in water, they come in contact and penetrate the flesh of freshwater fish, where they encyst as metacercariae . Infection of humans occurs by ingestion of undercooked, salted, pickled, or smoked freshwater fish . After ingestion, the metacercariae excyst in the duodenum and ascend the biliary tract through the ampulla of Vater . Maturation takes approximately 1 month. The adult flukes (measuring 10–25 mm by 3–5 mm) reside in small- and medium-sized biliary ducts. In addition to humans, carnivorous animals can serve as reservoir hosts. (From Global Health, Division of Parasitic Diseases and Malaria, CDC.) A flowchart of the life cycle of Trematode species.

Current Medical Diagnosis & Treatment 2025 > Clonorchiasis & Opisthorchiasis

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