Endoscopic Discovery and Capture of Necator americanus in the Stomach

Abstract

We report a case of the endoscopic discovery and removal of a specimen of Necator americanus hooked into the gastric mucosa of a black woman from Zaire. We extracted the parasite by means of biopsy forceps. Signs of previous bites were seen in the antrum. This exceptional localization might be due to a jejuno-duodeno-gastric reflux.

Endoscopic (video) demonstration of hookworm infestation of the stomach

“…They are not usually seen in the stomach. So far in the literature only a few reports of hookworm infestation of the stomach are available 2 3. The proposed mechanism by which the adult worm reaches the stomach might be the jejunoduodenogastric reflux.…”

In Vivo Endoscopic Imaging of Ancylostomiasis-Induced Gastrointestinal Bleeding: Clinical and Biological Profiles

“…In support of the first possibility are the occasional reports confirming visualization of the worms hooked into the gastric antrum as an ectopic site. 19,20 Furthermore, a heavy infection may spread hookworms along the whole gastrointestinal tract, including the stomach, duodenum, jejunum, proximal ileum, and down to the ascending and sigmoid colonic segments, which was reported in a patient examined both by capsule endoscopy and colonoscopy. 21 However, in support of the second possibility (i.e., that the gastric erosions were coincidental), several lesions were reported in a study from Thailand, including gastric ulcers, duodenal ulcers, and even gastric and colonic cancers, in some patients with hookworm infections and a mean age of 62 years.…”

Hookworm in the terminal ileum:a common cause of severe anaemia residing in a rare location

“…Other modality helpful in a clinically suspected case is upper gastro intestinal endoscopy, which detects parasites in their habitat. Apart from cases where hookworms have been recovered from duodenum and jejunum through upper gastro intestinal endoscopy [9][10][11][12][13][14][15], retrieval of hookworms from rare sites of intestine like ileum [3] caecum [3][4],colon [5] intestine(gastric antrum) [6] has also been reported by some workers. The ectopic localization in the antrum has been attributed to jejuno-duodeno-gastric reflux [5] while the recovery of hookworms from the cecum in one report [4] has been attributed to bowel preparation leading to washing the worms downstream.…”

“…When left untreated, hookworms cause internal blood loss leading to anaemia and malnutrition [1]. The adult worm lives in the small intestine of man particularly in the jejunum, sometimes in the duodenum [2] but rarely parasite may be found in other locations of intestine like ileum [3] caecum [3,4] or colon [5] or sometimes outside intestine as high as gastric antrum [6] Here we present an unusual case report of severe anaemia where the hookworm was recovered from terminal ileum through colonoscopy.…”