A 40-year male presented to the emergency department with the complaints of Fatigue that had progressively worsened over the period of 3 months. He had recently emigrated from Mexico, where he worked on a farm and eaten raw watercress. Clinical examination revels pallor of oral mucosa. Laboratory findings showed an increased in absolute Eosinophil count of 1400 cells per cubic millimeter (reference range 0-400). Ultrasonography of the abdomen reveled intrahepatic biliary ductal dilatation and magnetic resonance cholangiopancreatography revealed a hilar stricture. Endoscopic retrograde cholangiopancreatography was then performed and Large Flatworm were visualized emerging from major duodenal papilla.

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Corresponding author
Chaitanya Ajay Kulkarni, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India (chaitanyakulkarni143@gmail.com)