Yamashita Eduardo Tomohissa, Takahashi Wagner, Kuwashima Daniel Yuiti, Langoni Tiago Ribeiro, Costa-Genzini Adriana
Eduardo Tomohissa Yamashita, Wagner Takahashi, Daniel Yuiti Kuwashima, Tiago Ribeiro Langoni, Adriana Costa-Genzini, Advanced Center of Diagnostic and Therapeutic Endoscopy, UNIMED Santa Helena Hospital, 01508-000 São Paulo, Brazil.
World J Gastrointest Endosc. 2013 Apr 16;5(4):189-90. doi: 10.4253/wjge.v5.i4.189.
Ascaris lumbricoides (A. lumbricoides) is the most common intestinal roundworm parasite, infecting approximately one quarter of the world's population. Infection can lead to various complications because it can spread along the gastrointestinal tract. Although A. lumbricoides infection is a serious healthcare issue in developing countries, it now also has a worldwide distribution as a result of increased immigration and travel. Intestinal obstruction is the most common complication of A. lumbricoides infection, potentially leading to even more serious consequences such as small bowel perforation and peritonitis. Diagnosis is based primarily on stool samples and the patient's history. Early diagnosis, aided in part by knowledge of the local prevalence, can result in early treatment, thereby preventing surgical complications associated with intestinal obstruction. Further, delay in diagnosis may have fatal consequences. Capsule endoscopy can serve as a crucial, non-invasive diagnostic tool for A. lumbricoides infection, especially when other diagnostic methods have failed to detect the parasite. We report a case of A. lumbricoides infection that resulted in intestinal obstruction at the level of the ileum. Both stool sample examination and open surgery failed to indicate the presence of A. lumbricoides, and the cause of the obstruction was only revealed by capsule endoscopy. The patient was treated with anthelmintics.
蛔虫(似蚓蛔线虫)是最常见的肠道蛔虫寄生虫,感染了全球约四分之一的人口。由于它可沿胃肠道扩散,感染可导致各种并发症。尽管蛔虫感染在发展中国家是一个严重的医疗问题,但由于移民和旅行增加,它现在在全球范围内也有分布。肠梗阻是蛔虫感染最常见的并发症,可能导致更严重的后果,如小肠穿孔和腹膜炎。诊断主要基于粪便样本和患者病史。早期诊断,部分借助对当地患病率的了解,可实现早期治疗,从而预防与肠梗阻相关的手术并发症。此外,诊断延迟可能会产生致命后果。胶囊内镜可作为诊断蛔虫感染的关键非侵入性工具,尤其是在其他诊断方法未能检测到寄生虫时。我们报告一例蛔虫感染导致回肠水平肠梗阻的病例。粪便样本检查和开放手术均未提示蛔虫的存在,而梗阻原因仅通过胶囊内镜得以揭示。患者接受了驱虫药治疗。