Introduction to trematodaAssistanted Prof. Sheng

2. Digestive systemCompose with mouth pharynxesophagus cecum MORPHOLOGY1. SHAPELeaf-shapetong-shapeOral suckerventral sucker

ovaryootypeUterine tube Seminal receptacleLaurers canalEggmodelMeglands Vitelline glands and uterus.Strong , most of them are hermaphrodite3. Reproductive system

testes efferent ductule deferential duct seminal vesicle prostate penis packet of penis.

a. adult parasite in human being and mammal,worm parasite in aquatic animal (example:snail)Life cyclecomplication

b. Growing process include:eggmiracidiumsporocystrediacercariametacercariaYoung wormadult

Clonorchis sinensis

morphology1. adultShape:

Sucker:

Cecum:

Hermaphrodite:

2. eggShape :

Size:

Colour:

Egg shell:

Content:

Life cycleadultEgg Egg pass into water in fecesEgg are swallow by snail and hatch by itmiracidiumsporocystrediacercariaAll these stages grow in snailmetacercaria

Cercaria leave snail and eated by fresh-water fish Man is infected byEating uncooked fishYoung wormadult

Pathogenesis and clinical maniefstationThe pathogenesisAdults mechanical destructionSecretion and excretions toxicityIt cause the sell of duct fall off and cause the sell have hyperplasia and inflammation The tissue fibre The worm blockageThe duct wall become thickThe ductBecome narrowDuct blockageBile retention Duct expandThey cause liver sellAtrophy, necrosis and cirrhosis cirrhosis

The diseasesBlockage icterusCholangitis and hepatitisCholelithiasiscirrhosisLiver duct cancerActute hemorrhagic necrosis of pancreas

Adult parasite in the bile

cholelithiasis

cholelithiasis

Ascites and epigastric

Liver parm

Spider-shape vein

Actute hemorrhagic necrosis of pancreas

Clinical manifestationMost of them have no obvious symptom

Some feel tiredness ,hepatic enlargement, right upper quadrant mild pain ,abdominal pain ,anorexia, dizziness.

When it become serious the patient has ascites , unconscious and will die later.

DiagnosisDialogue about case histories:a. Whether come from epedemiologic area b. Whether have the habit of eating raw fresh water fish or shrimp

1.laboratory diagnosis : Detect eggs make sure diagnosisa. Stool examination Direct amear methodNature sedimentationmethodFormalin ether methodb. The duodenum secretion examination

2. Immunologic examinationIH test

IHA

ELISA3. Ultrasonic wave examination

epidemiology Local epidemic

Infective rate :1%~30%,some are 80%

Epidemic area: JapanKorea Vinan Thailand

China:

Epidemic factor:Infective resource: patient and carrier , reservoir hostSpread way:egg pass into water in feces intermediate host exit ,people have the habit of eating raw fish or raw shrimbSusceptible people : all people

treatment1.hygiene educationDo not eat raw fish or raw shrimbNot let cat eat raw fish or raw shrimb too2.treat the patient and carrier3. Not let the feces pass into the fresh-water