- Abdominal ultrasound is the most appropriate imaging modality for identifying complications of fascioliasis because it is non-invasive, readily available, and sensitive for detecting hepatobiliary abnormalities.
- It can visualize liver parenchymal changes, bile duct dilation, and the presence of flukes or biliary obstruction.
- Ultrasound allows immediate assessment of complications such as acute or chronic inflammation, biliary obstruction, and abscess formation.
- Compared to CT and MRCP, ultrasound is more practical and cost-effective for initial evaluation in endemic areas and guides further management.
- ERCP is reserved for therapeutic interventions rather than initial diagnosis.

Reference: Davidson’s Principles and Practice of Medicine, 24th Edition, Chapter: Diseases of the Liver and Biliary Tract, Page 753.