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Their adult stage develops in the biliary canals and gallbladder. Infection follows an initial, 3\u20134\u00a0month long invasive, migratory or acute phase, and a several year-long biliary, chronic or obstructive phase.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The unexpected finding of a fasciolid inside the gallbladder during a cholecystectomy for obstructive lithiasis suspicion in a patient is reported from an area of Iran where human infection had been never reported before and studies on fascioliasis in livestock are absent.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The fluke obtained was phenotypically classified as <jats:italic>F. hepatica<\/jats:italic> by morphometry and genotypically as <jats:italic>F. gigantica<\/jats:italic> by mtDNA <jats:italic>cox<\/jats:italic>1 fragment sequencing, although with <jats:italic>F. hepatica<\/jats:italic> scattered mutations in species-differing nucleotide positions. The clinical, radiological, and biological signs observed at the acute and chronic phases often lead to some misdiagnosis. Serological methods may be useful in cases of negative coprology. Diagnostic techniques with insufficient resolution leading to unnecessary invasive interventions are analyzed. The way to avoid unnecessary surgery is described, including analyses to be made, diagnostic tools to be used, and aspects to be considered.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Reaching a correct diagnosis in the confusing presentations avoids procedure delays and unnecessary surgery. A correct drug treatment may be sufficient. Except in extreme pathological presentations, lesions decrease in number and size and finally disappear or calcify after a successful treatment. Finally, the need to increase awareness of physicians about fascioliasis is highlighted, mainly in non-human endemic areas.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11686-023-00726-6","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T05:01:38Z","timestamp":1699333298000},"page":"891-902","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Fasciola Infection Unexpectedly Found During Cholecystectomy: Review on How to Avoid Increasing Surgery Interventions in Non-human Endemic Areas"],"prefix":"10.1007","volume":"68","author":[{"given":"Gholamreza","family":"Mowlavi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2347-7269","authenticated-orcid":false,"given":"Mar\u00eda Dolores","family":"Bargues","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faezeh","family":"Najafi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saied Reza","family":"Naddaf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alireza","family":"Salehabadi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir Kazem","family":"Vejdan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahboobeh","family":"Salimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arezoo","family":"Fadavi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Arab-Mazar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santiago","family":"Mas-Coma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,11,7]]},"reference":[{"key":"726_CR1","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/S0065-308X(09)69002-3","volume":"69","author":"S Mas-Coma","year":"2009","unstructured":"Mas-Coma S, Valero MA, Bargues MD (2009) Fasciola, lymnaeids and human fascioliasis, with a global overview on disease transmission, epidemiology, evolutionary genetics, molecular epidemiology and control. 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All have made substantive contributions to this work. The authors report no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"This study was performed in accordance with the ethical standards as laid down in the Declaration of Helsinki of 1975 and revised in 2008. The surgical intervention was practiced due to obstructive lithiasis suspicion in the Imam Reza Hospital, Birjand University of Medical Sciences, Birjand, Iran, after patient's consent. The surgically collected fasciolid specimen was anonymized before its transferring to the School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Approval for the study was obtained from the Birjand University of Medical Sciences and the Tehran University of Medical Sciences. All research management of the liver fluke sample surgically obtained from the hospital patient was made within a fascioliasis research line ethically approved by the School of Public Health, Tehran University of Medical Sciences, Iran (ethical code IR.TUMS.SPH.REC.1398.203). Laboratory research in Valencia was performed with the approval of the Evaluation of Projects at University of Valencia (Organo Habilitado para la Evaluaci\u00f3n de Proyectos de Experimentaci\u00f3n de la Universidad de Valencia) (A1263 915389140 and 2015\/VSC\/PEA\/00001 tipo 2), strictly following the institution\u2019s guidelines based on Directive 2010\/63\/EU.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Statements"}}]}}