Gastrointestinal bleeding due to worm infestation, with negative upper gastrointestinal endoscopy findings: Impact of enteroscopy
Gastrointestinal bleeding due to worm infestation, with negative upper gastrointestinal endoscopy findings: Impact of enteroscopy
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DOI：
10.1055/s-2000-7393
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发表时间：
2000-04-01
期刊：
影响因子：
9.3
通讯作者：
Singh, K
中科院分区：
文献类型：
--
作者：
Sharma, BC;Bhasin, DK;Singh, K
背景和研究目的：在钩虫和蛔虫感染的情况下，慢性隐匿性出血是众所周知的，但急性胃肠道出血很少描述。我们报告5例蠕虫感染谁提出了急性大规模消化道bleeding.Patients和方法：超过1年，我们遇到了15例不明原因的消化道出血。所有患者上消化道内镜检查均正常。推进肠镜进行了每一个病人和评价的近端40-50厘米的空肠done.Results：5例（4男，1女，平均年龄50岁，范围40-60）有蠕虫感染（钩虫，蛔虫）。所有患者均出现消化道出血（5例有黑便，1例呕血，2例便血），持续时间为7-14天。血红蛋白范围为2.8至9 g/dl。推进式肠镜检查显示空肠新鲜，多发性糜烂，2例患者有钩虫，3例患者有蛔虫。在2例患者中通过内窥镜取出钩虫，而仅在1例患者中取出蛔虫。所有患者均接受甲苯咪唑（100 mg，每日2次，连续3天）、铁和叶酸治疗。消化道出血消退，所有patients.Conclusions：在发展中国家，蠕虫感染应被认为是一个重要的原因不明急性消化道出血。使用肠镜评估空肠将导致更频繁地诊断蠕虫作为急性消化道出血的原因，这可能被归类为不明原因的消化道出血。
Background and Study Aims: In cases of hookworm and roundworm infestation, chronic occult bleeding is well known, but acute gastrointestinal bleeding is rarely described. We report five patients with worm infestation who presented with acute massive gastrointestinal bleeding.Patients and Methods: Over 1 year, we have encountered 15 patients with obscure gastrointestinal bleeding. All the patients had normal findings on upper gastrointestinal endoscopy. Push enteroscopy was performed in each patient and evaluation of the proximal 40-50 cm of the jejunum was done.Results: Five patients (four men, one woman; average age 50 yr, range 40-60) had worm infestation (two hookworm, three roundworm). All the patients had gastrointestinal bleeding (five had melena, one hematemesis, and two hematochezia) for a duration of 7-14 days. Hemoglobin ranged from 2.8 to 9 g/dl. Push enteroscopy revealed fresh Mood in the Jejunum, multiple erosions, and hookworms in two patients and roundworms in three patients. Hookworms were retrieved endoscopically in two patients whereas roundworms could be retrieved in only one patient. All the patients were treated with mebendazole (100 mg twice a day for 3 days), iron, and folic acid. Gastrointestinal bleeding subsided in all the patients.Conclusions: In developing countries, worm infestation should be considered an important cause of obscure acute gastrointestinal bleeding. Evaluation of the jejunum using an enteroscope will result in more frequent diagnosis of worms as a cause of acute gastrointestinal bleeding which might have been classified as obscure gastrointestinal bleeding.