A Case of Ascaris lumbricoides found out by Endoscopic Examination for Hematoemesis

Abstract

Case was a 63-year-old female. She was admitted to hospital because of hematoemesis. Laboratory data showed slight anemia, increasing data of eosinophil and IgG. No pathological findings were recognized by chest plain X-ray films and abdominal CT scan, At first, we suspected rupture of esophago-gastric varices, portal hypertensive gastropathy and so on, because she attended our hospital for Primary biliary cirrhosis. Upper GI endoscopy performed in an emergency showed oozing from multiple erosions in the stomach. She was hospitalized by the diagnosis of acute gastric mucosal lesion. We performed 2nd upper GI endoscopy on 3 hospitalized days for checking the state of affairs. Endoscopic pictures showed a white roundworm in 2nd portion of the duodenum. This worm could be removed by grasping forceps led to the diagnosis of Ascaris lumbricoides. And then, She was cured of this disease by taking Pyrantel pamoate. In recent years, the Incidence of Ascaris lumbricoides has been decreasing because of improved public hygiene and living standards in Japan. However, there is a slight increasing in number of cases due to the natural foods boom and increasing contact with foreign countries. In this case, the origin was natural foods. It is necessary for clinicians to be able to take parasitosis into consideration.