Hepatic Fascioliasis Complicated by Hepatic Cyst in Communication with the Biliary Tree and Secondary Sclerosing Cholangitis
Bibliographic record
Abstract
To review a case of Fasciola hepatica with the complications of secondary sclerosing cholangitis (SSC) and hepatic cyst in communication with the biliary tree. Infection with the liver fluke Fasciola hepatica is rarely reported in both Canada and the United States. A 27 year-old Caucasian female presented with right upper quadrant pain, hypodense hepatic lesions, and eosinophilia two months after returning from Mexico, where she had adventurous eating habits and recalled watercress ingestion. A diagnosis of hepatic fascioliasis was made on the basis of clinical and radiologic presentation in conjunction with serum antibody testing. After treatment, with triclabendazole, her pain did not fully resolve. Percutaneous drainage of one of the hepatic cysts was performed yielding bilious fluid. ERCP revealed direct communication of the hepatic cyst with a branch of the right intrahepatic duct and sclerosing cholangitis. A literature review did not identify any other cases of communicating hepatobiliary cyst secondary to Fasciola infection. There have been several reports SSC after years of chronic Fasciola infection, but none with the patient this close to the acute phase of infection. The hepatobiliary cyst was treated with endoscopic stenting resulting in incremental shrinkage in the size of the cyst as well as improvement in pain. The SSC is asymptomatic, with preserved synthetic function. As the implicated cause of the sclerosis has been identified and corrected it is felt that the patient has a good prognosis and that further progression of the sclerosis is unlikely. There is unlikely to be an increased risk of cholangiocarcinoma in this patient as neither Fasciola infection nor SSC is associated with heightened incidence of malignancy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".