barw Judi Clinical Journal 3105-4102 2 1 2026 06 21 Hepatopulmonary Fascioliasis Presenting with Lung Abscess: A Case Report and Literature Review 54 57 10.70955/JCJ.2026.37 eng Sivan H. Salih Gastroenterology Department, Gastroenterology and Hepatology Teaching Hospital, Zanko Street, Sulaymaniyah, Iraq Soran H. Tahir Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Dana T. Gharib Gastroenterology Department, Gastroenterology and Hepatology Teaching Hospital, Zanko Street, Sulaymaniyah, Iraq Hoshmand R. Asaad Gastroenterology Department, Gastroenterology and Hepatology Teaching Hospital, Zanko Street, Sulaymaniyah, Iraq Fahmi H. Kakamad Department of Clinical Sciences, College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq 0000-0002-2124-9580 Harem K. Ahmad Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Amanj K. Hamad Department of Pulmonology, German Hospital for Management of Respiratory Diseases, Shorsh Street, Sulaymaniyah, Iraq Kayhan A. Najar Kscien Organization for Scientific Research (Middle East Office), Hamdi Street, Sulaymaniyah, Iraq Rahand A. Yousif Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq Berun A. Abdalla Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq 2026 05 25 Introduction: Fascioliasis is a rare food-borne parasitic infection primarily of the hepatobiliary system caused by Fasciola hepatica. The liver is the principal site of infection, and involvement of other organs is infrequent. This report presents a rare case of fascioliasis associated with a lung abscess. Case presentation: A 37-year-old female presented with abdominal pain and hematochezia. General examination was normal. Computed tomography (CT) scan showed multiple hypodense liver lesions with peripheral enhancement, with moderate left pleural effusion and a left lower lobe cavitary lesion. Ultrasonography (US) showed cystic liver lesions with curvilinear tracts. She underwent VATS (Video-assisted thoracic surgery) wedge resection of the left lower lobe cavitary lesion. She then received triclabendazole (TCBZ). Follow-up US showed new liver lesions, so a second course of TCBZ was given. Subsequently, the patient improved and was asymptomatic at the last follow-up. Literature review: A review of seven reported cases of fascioliasis between 2013 and 2024 was performed, of which only two cases had pulmonary involvement. Five patients were females (71.43%), with a mean age of approximately 45 years (range:  late 20s-58 years). The most prevalent presentation was fever in five cases (71.43%). Eosinophilia was present in six cases (85.71%). On clinical examination, abdominal tenderness was noted in three patients (42.86%).  Management was exclusively conservative in six cases (85.71%). Conclusion: This report highlights the diagnostic challenges of fascioliasis with extrahepatic involvement. Pulmonary findings require careful evaluation, and clinicians should maintain a high index of suspicion for ectopic fascioliasis, even without definitive parasitological confirmation.