Successful diagnosis by capsule endoscopy of small intestinal ascariasis that had been misdiagnosed repeatedly.

Autor: Zeng SX; Department of Gastroenterology and Endoscopy Center, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, China., Luo QT; Department of Gastroenterology and Endoscopy Center, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, China., Chen HL; Department of Gastroenterology and Endoscopy Center, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, China., Zan JY; Department of Gastroenterology and Endoscopy Center, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, China., Cheng CS; Department of Gastroenterology and Endoscopy Center, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, China.
Jazyk: angličtina
Zdroj: Gastrointestinal endoscopy [Gastrointest Endosc] 2024 May; Vol. 99 (5), pp. 856-858. Date of Electronic Publication: 2023 Dec 14.
DOI: 10.1016/j.gie.2023.12.016
Abstrakt: Competing Interests: Disclosure Supported by Guangdong Basic and Applied Basic Research Foundation (project No. 2021A1515110799 and No. 2023A1515010144) and Shenzhen Science and Technology Program (project No. JCYJ20220530142000001) and Shenzhen Nanshan District Science and Technology Plan Funding Program (project No. NS2021077). All authors disclosed no financial relationships. CommentaryAscaris lumbricoides is a large parasitic roundworm and is responsible for one of the most common helminth human infections worldwide. Many infections are asymptomatic, but GI symptoms can develop in the late adult worm stage when the worms inhabit the GI tract, where they can cause a range of symptoms from vague abdominal pain to pancreatitis, cholangitis, and even appendicitis. Although ascariasis is generally thought to be a disease of children from Asia, Africa, and South America, it is important to keep it in the differential diagnosis even in older patients from nonendemic areas. Clues to diagnosis include peripheral eosinophilia and the results of stool microscopy, and in late stages the worms can also frequently be picked up on abdominal imaging studies. However, in cases where the symptoms are vague and in the absence of the findings just mentioned, diagnosis can be delayed. In these 2 cases of patients with ascariasis, neither of the patients was from an endemic rural area, both were mature adults, and both presented with vague abdominal symptoms. In addition, the worms were found in different areas of the GI tract, including the ascending colon and the appendiceal orifice on colonoscopy and the small intestine on capsule endoscopy. In patients with vague abdominal symptoms and negative workup results, ascariasis infection should remain in the differential diagnosis, especially in the presence of less well-known risk factors such as a tendency for raw meat ingestion. Luckily, the infection is easily treatable with albendazole, although it is important to remember that prior infection does not confer protective immunity. Amy Tyberg, MD, FASGE, FACG, Associate Editor for Focal Points
Databáze: MEDLINE
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