Clin Endosc.  2013 Nov;46(6):671-674.

A Case of Parasite Invasion of the Intestinal Tract: A Missed Diagnosis in Irritable Bowel Syndrome

Affiliations
  • 1Onnuri-Su Medical Clinic, Daejeon, Korea.
  • 2Department of Internal Medicine, Research Institute for Medical Science, Chonbuk National University College of Medicine, Jeonju, Korea. clickm@jbnu.ac.kr
  • 3Department of Internal Medicine, Research Institute of Clinical Medicine Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.

Abstract

Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause. As the clinical manifestations are very diverse and associated with nonspecific symptoms, research seeking to identify organic causes to rule out IBS and to enable differential diagnosis is required. A 24-year-old man was referred to our hospital for specialized management of IBS. He had a 7-month history of intermittent epigastric and lower abdominal pain. On the basis of clinical examination, he was diagnosed with IBS and administered medication at a primary clinic. However, his symptoms did not improve after treatment. We performed capsule endoscopy at our hospital and identified a parasite (Ancylostoma duodenale) in the proximal jejunum. We therefore report a case of parasitic infection found by additional examination while evaluating symptoms associated with a previous diagnosis of refractory IBS.

Keyword

Irritable bowel syndrome; Parasitic infection; Ancylostoma duodenale; Ancylostomatoidea

MeSH Terms

Abdominal Pain
Ancylostoma
Ancylostomatoidea
Capsule Endoscopy
Diagnosis*
Diagnosis, Differential
Humans
Irritable Bowel Syndrome*
Jejunum
Parasites*
Young Adult

Figure

  • Fig. 1 Capsule endoscopic findings. (A) Whitish round-shaped linear organism in the proximal jejunum, suggestive of a parasite. (B) Capsule endoscopy image showing multiple nodular erosive lesions around the organism. (C) More large-sized erosive lesions were noted around the organism.


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