Mansoor Sahibzada Nasir, Anwar Zahid, Sheen Salman Najam
Department of Rehabilitation Medicine, Combined Military Hospital (CMH), Kohat, KPK.
Department of Surgery, Combined Military Hospital (CMH), Kohat, KPK.
J Coll Physicians Surg Pak. 2016 Feb;26(2):156-7.
Leeches are found in fresh water as well as moist marshy tropical areas. Orifical Hirudiniasis is the presence of leech in natural human orifices. Leech have been reported in nose, oropharynx, vagina, rectum and bladder but leech per urethra is very rare. We report a case of leech in urethra causing hematuria and bleeding disorder in the form of epistaxis and impaired clotting profile after use of stream water for ablution. The case was diagnosed after a prolonged diagnostic dilemma. Asingle alive leech was recovered from the urethra after ten days with the help of forceps. The hematuria and epistaxis gradually improved over next 48 hours and the patient became asymptomatic. Natives of leech infested areas should be advised to avoid swimming in fresh water and desist from drinking and using stream water without inspection for leeches.
水蛭见于淡水以及潮湿的热带沼泽地区。腔道水蛭病是指水蛭出现在人体天然腔道内。水蛭曾被报道出现在鼻腔、口咽、阴道、直肠和膀胱，但尿道内出现水蛭极为罕见。我们报告一例因使用溪水冲洗后尿道内出现水蛭，导致血尿以及鼻出血形式的出血紊乱和凝血指标受损的病例。该病例在经历长时间的诊断困境后得以确诊。十天后借助镊子从尿道中取出一条活的水蛭。血尿和鼻出血在接下来的48小时内逐渐好转，患者恢复无症状。应建议水蛭滋生地区的居民避免在淡水中游泳，在未经检查是否有水蛭的情况下，不要饮用和使用溪水。
