患者，女，66岁，农民，2022年2月15日因“上腹部胀痛伴恶心不适7天”至当地县医院就诊，行腹部CT，示胆总管扩张，肝左叶肝内胆管结石并左叶胆管扩张，肝左叶萎缩；次日转至中国人民解放军联勤保障部队第九二四医院。患者生活于广西桂林山区，长期直接饮用山泉水及食生鱼腥草。入院后查体，剑突下压痛，无反跳痛；血常规无明显异常。MRI检查提示：肝左叶萎缩，肝左叶肝内胆管扩张，其近端内多发颗粒状T2低信号影，胆总管扩张，其内见条状T2低信号影。排除相关手术禁忌征后行内镜逆行胰胆管造影术，术中用取石网篮取出1条灰褐色活体成虫，予留置鼻胆管引流。虫体转送桂林医学院基础医学院人体寄生虫学教研室，鉴定为肝片形吸虫。术后予每12 小时口服阿苯达唑0.6 g、吡喹酮0.6 g，治疗2 d。术后2个月复诊，患者无不适；复查腹部CT提示肝左叶萎缩，肝左叶肝内胆管及胆总管扩张。

A 66-year-old female patient, who was a farmer, went to the local county hospital on February 15, 2022 for treatment due to upper abdominal pain and nausea for 7 days. The abdominal CT examination showed dilatation of the common bile duct, intrahepatic bile duct stones in the left lobe of the liver and dilatation of the left lobe of the bile duct, and atrophy of the left lobe of the liver. She was transferred to the 924 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army in the following day. The patient lived in the mountain area of Guilin, Guangxi and had history of drinking uncooked mountain spring water and ate raw Houttuynia cordata for a long time. There was positive tenderness but no rebound pain under the xiphoid process at admission examination. Laboratory test showed normality in routine blood test. Abdominal enhanced MRI examination showed that the left lobe of liver was atrophied, the intrahepatic bile duct in the left lobe of liver and common bile duct were significantly dilated, and granular or strip T2 low signal shadow was seen in the bile duct. After excluding the relevant surgical contraindications, endoscopic retrograde cholangiopancreatography was performed. During the operation, a viable Fasciola hepatica was removed with a basket, and the nasal bile duct was retained for drainage. The worm was transferred to the Department of Human Parasitology in Basic Medical College of Guilin Medical College and identified as Fasciola hepatica. After the operation, 0.6 g of albendazole and 0.6 g of praziquantel were given orally every 12 hours for 2 days. After two months of operation, the patient had no symtoms. CT examination showed atrophy of the left lobe of the liver and dilation of intrahepatic bile duct in the left lobe of the liver and common bile duct.