An unusual cause of chest discomfort: case report of oesophageal hirudiniasis

Abstract

Hirudiniasis is caused by sanguivorous leeches feeding on mucous membranes with possible severe obstructive or haemorrhagic manifestations. Few cases have been reported in humans, and most occur in tropical countries. A seventy-year-old female patient presented to our Emergency Department (ED) with retrosternal discomfort. She was taking warfarin for a mechanical prosthetic heart valve. While in the ED, a leech was spontaneously extruded from her mouth, with symptomatic resolution. Endoscopy revealed an area of previous leech attachment in the distal oesophageal, without severe bleeding. Albeit uneventful, this case could have had a devastating outcome.

Esophageal Hirudiniasis: an Unusual Cause of Upper Gastrointestinal Bleeding

“…On the other hand, the esophageal site seems to be rare. To the best of our knowledge, a single case of esophageal leech infestation was published [ 19 ]. It was a 72-year-old female who, similarly to our patient, experienced retrosternal discomfort.…”

“…It was a 72-year-old female who, similarly to our patient, experienced retrosternal discomfort. About 3 days later, a leech extruded from her mouth and upper GI endoscopy revealed the leech former attachment site in the distal esophagus [ 19 ].…”