Takahashi Keitaro, Ito Takahiro, Sato Tomonobu, Goto Mitsuru, Kawamoto Toru, Fujinaga Akihiro, Yanagawa Nobuyuki, Saito Yoshinori, Nakao Minoru, Hasegawa Hideo, Fujiya Mikihiro
Department of Gastroenterology, Asahikawa-Kosei General Hospital, Asahikawa, Japan.
Department of Parasitology, Asahikawa Medical University, Asahikawa, Japan.
Clin J Gastroenterol. 2016 Jun;9(3):114-7. doi: 10.1007/s12328-016-0646-7. Epub 2016 Apr 20.
Corynosoma is a parasite that can normally be found in the intestinal tract of fish-eating mammals, particularly in seals and birds. The present case proposed that Corynosoma could attain full maturity in the human intestine. A 70-year-old female complained of abdominal pain. A computed tomography (CT) scan revealed a swelling of the intraperitoneal lymph nodes with no responsible lesion. Video capsule endoscopy and double-balloon endoscopy detected several ulcerations and one parasite in the ileum, which was tightly attached at the bottom of the ulcerations. The parasite was cylindrical and measured approximately 10 mm (long) x 3 mm (wide). Pathologically, the worm had a four-layered body wall and contained embryonated eggs. The sequences of the parasite-derived nuclear ribosomal DNA fragment and mitochondrial DNA fragment of cox1 were almost identical to those of Corynosoma validum. The patient's abdominal pain immediately improved after the administration of pyrantel pamoate (1,500 mg). Corynosoma was possibly the responsible disease in a patient who complained of abdominal pain and in whom no responsible lesion was detected by CT, gastroduodenoscopy or colonoscopy. Examinations of the small intestines should be aggressively performed in such cases.
犬复孔绦虫是一种寄生虫,通常可在食鱼哺乳动物的肠道中发现,尤其是在海豹和鸟类体内。本病例表明犬复孔绦虫可在人体肠道内发育成熟。一名70岁女性主诉腹痛。计算机断层扫描(CT)显示腹腔淋巴结肿大,但未发现病因。视频胶囊内镜和双气囊内镜检查在回肠发现了几处溃疡和一条寄生虫,该寄生虫紧紧附着在溃疡底部。该寄生虫呈圆柱形,长约10毫米,宽约3毫米。病理检查显示,该虫体有四层体壁,内含胚胎卵。该寄生虫的核糖体DNA片段和细胞色素氧化酶亚基1(cox1)线粒体DNA片段序列与犬复孔绦虫几乎相同。服用噻嘧啶(1500毫克)后,患者的腹痛立即得到缓解。对于主诉腹痛且CT、胃十二指肠镜或结肠镜检查未发现病因的患者,犬复孔绦虫可能是病因。在此类病例中,应积极进行小肠检查。