Background: Fascioliasis is a neglected tropical disease caused by Fasciola species that can present with nonspecific abdominal symptoms and mimic surgical emergencies. Case Presentation: We report a 12-year-old Ethiopian boy who presented with right-sided abdominal pain, fever, and marked eosinophilia and was initially suspected to have acute appendicitis. Diagnostic laparoscopy revealed hepatic rather than appendiceal pathology. Imaging demonstrated subcapsular hepatic tracks, and serologic testing confirmed Fasciola species infection (most probably Fasciola gigantica in the Ethiopian context). Histopathology showed eosinophil-rich granulomatous hepatitis with helminthic structures. The patient was treated with triclabendazole and recovered completely. Conclusion: This case highlights the importance of considering parasitic infections such as fascioliasis in children presenting with atypical acute abdominal pain in endemic regions. Early use of imaging and serologic testing may prevent unnecessary surgical interventions and allow timely curative therapy.
Bekele et al. (Wed,) studied this question.