Bektas Meltem, Yarimoglu Rafet, Ozcan Ayse, Baltaci Bulent, Basar Hulya
Department of Anaesthesiology and Reanimation, Ankara Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
Department of Anaesthesiology and Reanimation, Karaman Training and Research Hospital, Karamanoğlu Mehmetbey University, Karaman, Turkey.
Iran J Parasitol. 2023 Apr-Jun;18(2):268-271. doi: 10.18502/ijpa.v18i2.13195.
Leeches are rare cause of foreign body in airways. A 23-year-old male, experiencing epistaxis and difficulty in swallowing is presented. During nasopharyngoscopy, a moving leech was observed on the nasopharynx posterior wall in midline location, and removal of the leech was decided under general anaesthesia. The flexible nasopharyngoscopy was inserted, but removal was unsuccessful due to the leech's movements. Leeches are blood-sucking parasites, so neuromuscular blocking agent was given to prevent the movement. After administration, motion of the leech was lost and easily removed undamaged. In patients presenting with unexplained epistaxis, hemoptysis, dyspnea, and foreign body sensation in the airway, leech infestation should be included as the differential diagnosis and history of contact with stream water should be questioned. We concluded that use of low dose neuromuscular blocking agents facilitates the gentle removal, and could be necessary for successful management of removal of leech under general anaesthesia.
水蛭是气道异物的罕见病因。本文报告一名23岁男性，出现鼻出血和吞咽困难。在鼻咽喉镜检查中，发现一条水蛭位于鼻咽后壁中线位置且在移动，遂决定在全身麻醉下取出水蛭。插入了可弯曲鼻咽喉镜，但由于水蛭的移动，取出未成功。水蛭是吸血寄生虫，因此给予神经肌肉阻滞剂以防止其移动。给药后，水蛭停止移动并顺利无损取出。对于出现不明原因鼻出血、咯血、呼吸困难和气道异物感的患者，应将水蛭感染纳入鉴别诊断，并询问其与溪水接触的病史。我们得出结论，使用低剂量神经肌肉阻滞剂有助于轻柔取出，对于在全身麻醉下成功取出水蛭可能是必要的。
