Hypoglycaemia in suppurative pancholanghtis due to Clonorchis Sinensis

Publisher Website
Google Scholar
Abstract
Over a period of 16 years, 11 deeply unconscious patients were admitted, with high fever and showing varying degrees of jaundice. In all the coma was associated with severe hy-poglycemia, and correction of this resulted in restoration of consciousness. The histories of the last 10 patients were remarkably similar. After 1-4 days of fever and right upper abdominal discomfort there were repeated rigors associated with distressing distending pain over the liver coupled with vomiting. All lost consciousness within 24 hours of the onset of rigors. The laboratory findings are briefly described. The findings at necropsy in 9 and at laparotomy in 2 were those of a diffuse suppurative pancholangitis associated with obstruction of the extrahepatic ducts by large numbers of dead Clonorchis sinensis. It is concluded that surgical removal of the plug of dead flukes and drainage of the biliary tree are essential in the management of the condition and that it should be carried out as early as possible. An investigation of the cause of the hypoglycemia is described and it is concluded that it results from a hepatectomy-like effect. How the infection exerts this effect has not been determined. It is not due to necrosis of liver cells and is rapidly reversible through adequate treatment.

This publication has 9 references indexed in Scilit: