Elsaid Nada, Mahmood Humza, Tekkis Paris, Tan Emile
Chelsea and Westminster Hospital, London, UK.
BMJ Case Rep. 2014 Jan 15;2014:bcr2013201599. doi: 10.1136/bcr-2013-201599.
A 55 -year-old Asian man was seen in the emergency department with bleeding per rectum. He was a teetotaller and had no previous abdominal surgery. He did, however, report a change in bowel habit towards constipation. He underwent colonoscopy which revealed a lesion, highly suspicious of malignancy, in the caecum. On review by two consultants, a decision to completely resect this lesion was made. Histological analysis of the polypoidal growth showed it to be a consequence of chronic infection with the helminth Enterobius vermicularis. Importantly, there was no evidence of dysplastic or malignant cells. The patient was subsequently discharged with a 3-day course of antihelminthic mebendazole and reassured that his per rectal bleeding was most likely due to haemorrhoids discovered at rectal examination.
一名55岁的亚洲男性因直肠出血被送往急诊科。他滴酒不沾,之前没有做过腹部手术。然而,他确实报告说排便习惯有改变,出现了便秘。他接受了结肠镜检查,结果显示盲肠有一个高度怀疑为恶性肿瘤的病变。在两位会诊医生的评估后,决定对该病变进行完全切除。对息肉样肿物的组织学分析表明,这是由蠕形住肠线虫慢性感染所致。重要的是,没有发育异常或恶性细胞的证据。患者随后出院,服用了为期3天的抗蠕虫药甲苯咪唑,并得到保证,其直肠出血很可能是由于直肠检查时发现的痔疮。