Gastric echinostomiasis diagnosed by endoscopy

Foodborne Intestinal Flukes in Southeast Asia

“…In the Republic of Korea, an endemicity of this echinostome infection, with 22.4% prevalence, was reported among residents of Cheongsong-gun [124]. In hospitals of the Republic of Korea, clinical cases are at times diagnosed by extracting worms through gastroduodenal endoscopy [125][126][127][128][129].…”

“…The severity of symptoms is generally stronger than those seen in other intestinal fluke infections, such as heterophyids [5]. In this respect, reports of patients with E. hortense infection is noteworthy who sufferred from severe epigastric discomfort and ulcerative lesions in the stomach or duodenum and diagnosed by recovery of worms at gastroduodenal endoscopy [125][126][127][128][129]. A patient admitted to a hospital because of epigastric pain and hematemesis revealed in gastroduodenoscopy an adult fluke attached at the lesion, which was removed by an endoscopic clipper [125].…”

“…A patient admitted to a hospital because of epigastric pain and hematemesis revealed in gastroduodenoscopy an adult fluke attached at the lesion, which was removed by an endoscopic clipper [125]. Another patient suffered from epigastric discomfort for a year, and acute epigastric pain and diarrhea for 1 month, which was accompanied by acidic belching, dizziness, and weight loss of 2 kg [126]. The third patient complained of epigastric discomfort for several days [127], and the fourth patient suffered from upper abdominal pain and discomfort persisting for 2 wk [128].…”

“…These ulcerations were suggested to be caused by the flukes [125]. Upper endoscopy of another patient revealed 2 E. hortense worms in the stomach; 1 worm was penetrating into the mucosa on the lesser curvature of the antrum; the other was attached to the mucosal surface of the greater curvature of the antrum [126]. The worm wiggled on stimulation and became tightly stretched during retrieval with a forcep [126].…”

“…Upper endoscopy of another patient revealed 2 E. hortense worms in the stomach; 1 worm was penetrating into the mucosa on the lesser curvature of the antrum; the other was attached to the mucosal surface of the greater curvature of the antrum [126]. The worm wiggled on stimulation and became tightly stretched during retrieval with a forcep [126]. Two more patients diagnosed at gastroduodenal endoscopy had 2 living wroms each in the duodenal bulb area, at times accompanied by mucosal erosions [127,128].…”