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Novel diagnostic procedure
Capsule endoscopy is a feasible procedure for identifying a Diphyllobothrium nihonkaiense infection and determining the indications for vermifuge treatment
  1. Yoshiki Nomura1,
  2. Mikihiro Fujiya1,
  3. Takahiro Ito1,
  4. Katuyoshi Ando1,
  5. Ryuji Sugiyama1,
  6. Toshie Nata1,
  7. Nobuhiro Ueno1,
  8. Shin Kashima1,
  9. Chisato Ishikawa1,
  10. Yuhei Inaba1,
  11. Kentaro Moriichi1,
  12. Kotaro Okamoto1,
  13. Tetsuya Yanagida2,
  14. Akira Ito2,
  15. Katsuya Ikuta1,
  16. Jiro Watari3,
  17. Yusuke Mizukami1,
  18. Yutaka Kohgo1
  1. 1Department of Medicine, Division of Gastroenterology and Hematology/Oncology, Asahikawa Medical College, Asahikawa, Japan
  2. 2Department of Parasitology, Asahikawa Medical College, Asahikawa, Japan
  3. 3Department of Internal Medicine, Division of Upper Gastroenterology, Hyogo College of Medicine, Nishinomiya, Japan
  1. Correspondence to Mikihiro Fujiya, fjym{at}


Diphyllobothrium is a member of Cestoda family, which is the largest parasite of humans. The diagnosis of diphyllobothriasis is based on the detection of eggs in the stool. Because the remainder of the scolex causes a relapse in diphyllobothriasis, the scolex must be completely discharged to cure the parasite infection. However, the scolex or forefront of the Diphyllobothrium is difficult to detect with gastroduodenoscopy and colonoscopy, because most Diphyllobothrium attach to the jejunal wall. In the present case, capsule endoscopy detected proglottids as well as forefront of the parasite at jejunum. Based on the results of capsule endoscopy, the patient underwent additional vermifuge (anthelminthic) treatment to cure the diphyllobothriasis and discharged a worm measuring 3 m in length with a scolex. Capsule endoscopy is a practical option to determine whether additional vermifuge treatment is required through the detection of the proglottids as well as a scolex or forefront of the parasite.

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  • Competing interests None.

  • Patient consent Obtained.

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