Liver Flukes on Endoscopy Here are liver flukes (Fasciola hepatica) extracted from the bile duct during ERCP in a 20F with cholangitis. Their cysts hatch in the duodenum, burrow through the lining of the intestine and into the peritoneal cavity. They then migrate through the intestines and liver, and into the bile ducts. Inside the bile ducts, they develop into an adult fluke by Dr. Sary Ibrahim @DrSary2011 via Dr. Keith Siau @drkeithsiau #Liver #Flukes #ERCP #Fasciola #hepatica #parasites #clinical #EGD #Endoscopy #gastroenterology