Intestinal hookworm infestation causing chronic anaemia

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.