Nomura Yoshiki, Fujiya Mikihiro, Ito Takahiro, Ando Katuyoshi, Sugiyama Ryuji, Nata Toshie, Ueno Nobuhiro, Kashima Shin, Ishikawa Chisato, Inaba Yuhei, Moriichi Kentaro, Okamoto Kotaro, Yanagida Tetsuya, Ito Akira, Ikuta Katsuya, Watari Jiro, Mizukami Yusuke, Kohgo Yutaka
Department of Medicine, Division of Gastroenterology and Hematology/Oncology, Asahikawa Medical College, Asahikawa, Japan.
BMJ Case Rep. 2010 Aug 31;2010:3023. doi: 10.1136/bcr.05.2010.3023.
Diphyllobothrium is a member of Cestoda family, which is the largest parasite of humans. The diagnosis of diphyllobothriasis is based on the detection of eggs in the stool. Because the remainder of the scolex causes a relapse in diphyllobothriasis, the scolex must be completely discharged to cure the parasite infection. However, the scolex or forefront of the Diphyllobothrium is difficult to detect with gastroduodenoscopy and colonoscopy, because most Diphyllobothrium attach to the jejunal wall. In the present case, capsule endoscopy detected proglottids as well as forefront of the parasite at jejunum. Based on the results of capsule endoscopy, the patient underwent additional vermifuge (anthelminthic) treatment to cure the diphyllobothriasis and discharged a worm measuring 3 m in length with a scolex. Capsule endoscopy is a practical option to determine whether additional vermifuge treatment is required through the detection of the proglottids as well as a scolex or forefront of the parasite.
阔节裂头绦虫是绦虫家族的一员，是人体最大的寄生虫。阔节裂头绦虫病的诊断基于粪便中虫卵的检测。由于裂头蚴的残余部分会导致阔节裂头绦虫病复发，必须将裂头蚴完全排出才能治愈寄生虫感染。然而，阔节裂头绦虫的裂头蚴或前端很难通过胃十二指肠镜检查和结肠镜检查发现，因为大多数阔节裂头绦虫附着在空肠壁上。在本病例中，胶囊内镜在空肠发现了节片以及寄生虫的前端。基于胶囊内镜检查结果，患者接受了额外的驱虫（抗蠕虫）治疗以治愈阔节裂头绦虫病，并排出了一条长3米、带有裂头蚴的虫体。胶囊内镜是一种实用的方法，可通过检测节片以及寄生虫的裂头蚴或前端来确定是否需要额外的驱虫治疗。
