1. Diagnosis: Clonorchiasis infestation
ERCP: Clonorchis sinensis
Clonorchis sinensis is a human liver fluke
This parasite is found mainly in the common bile duct and gallbladder.
Endemic area: Korea, Japan, China, Taiwan, and Southest Asia

2. Clonorchiasis infestation
HAP
CT findings
Diffuse dilatation of the peripheral intrahepatic bile ducts, without dilatation of extrahepatic bile duct
Active infection could be differentiated from cured clonorchiasis by using the periductal hyperenhancement (arrows) especially on HAP.

3. Clonorchiasis infestation
US findings
Diffuse dilatation of the peripheral intrahepatic bile ducts and increased periductal echogenicity (representing a thickening of ductal wall due to mucosal hyperplasia and periductal fibrosis)
Floating echogenic foci in the gallbladder (indicating worms or desquamated material), suggesting active clonorchiasis

4. References
Am J Roentgenol 1990;155:
Radiology 2003;228:
J Clin Ultrasound 2004;32:17-23
Korean J Parasitol 2007;45(2):77-85