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Intestinal hookworm infestation causing chronic anaemia
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  1. Marcello Cintolo,
  2. Lorenzo Dioscoridi,
  3. Mutaz Massad and
  4. Massimiliano Mutignani
  1. Digestive and Interventional Endoscopy Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy
  1. Correspondence to Dr Lorenzo Dioscoridi, dioscoridi.lorenzo{at}virgilio.it

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Description 

This image (figure 1) is a photogram of a small-bowel capsule endoscopy and shows an intestinal Taenia spp causing persistent anaemia (requiring several blood transfusions) due to many jejunal and ileal mucosal erosions (figure 2) in a 52-year-old patient under oral anticoagulant therapy. Both a previous oesophagogastroduodenoscopy and colonoscopy were negative for any bleeding source. Subsequent capsule endoscopy was performed to investigate this occult blood loss.1 2 The examination showed many mucosal erosions of the small bowel and a flat, segmented intestinal worm recognisable as a Taenia spp. After an adequate antiparasitic therapy, the patient reported no more anaemia. This is a rare finding during capsule endoscopy and was not evidenced by the analysing system.1 Our case is in line with the reported cases in the available literature about intestinal worms’ finding during capsule endoscopy.1 2

Figure 1

The intestinal wo rm seen at 11  hours 07 min during the capsule endoscopy.

Figure 2

Mucosal multiple erosions caused by the intestinal wo rm.

Patient’s perspective

I would like to thank you all the Endoscopy Team of Niguarda Hospital. My life was ruined by this chronic anaemia. I felt sick for all these months. Now, after few days of oral medications, I returned to life!

Learning points

  • View and study all capsule endoscopy examination, especially if the ‘main photograms’ are not diagnostic.

  • Think also about the rare cases of anaemia especially in case of occult blood loss.

References

Footnotes

  • Contributors MC studied the examination and found the intestinal warm. MMa revised the manuscript and the figures. LD prepared the manuscript. MMu revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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