Hookworm Infection as a Rare Cause of Acute Pancreatitis

Abstract

The aim of this case report is to alert physicians to the possibility that hookworm disease can lead to acute pancreatitis. Method: We report a case of hookworm infestation associated with acute pancreatitis and food intolerance. Result: The patient presented on the emergency department complaining of anorexia, asthenia, nausea, vomiting, epigastric pain and fever. Blood test showed a amylase of 512U/L and a lipase of 1902, normal levels of hepatic aminotransferases, bilirubin and alkaline phosphatase and a slight elevation of the Creactive protein. An ultrasound showed no cholelithiasis, thickening of vesicular wall or dilation of the common bile duct and the computed tomography (CT) showed a normal pancreas with no evidence of cholecystitis or peripancreatic fluid. An upper digestive endoscopy was done because of food intolerance and revealed gastric stasis and duodenal mucosa congestive, friable, with loss of the usual pleating with biopsies revealing the presence of Ancylostoma duodenale. The patient was treated with albendazole and remains asymptomatic in a 3-year follow-up. Conclusion: Hookworm infestation is usually asymptomatic. Ampulla of Vater-migrating hookworms resulting in acute pancreatitis is a very rare event.