Intraperitoneal leech: A rare complication of leech bite

Abstract

An intraperitoneal leech, which entered through vagina and uterus in a 2-year-old girl is reported. The child presented with intraperitoneal hemorrhage and shock. A leech inside the peritoneal cavity has never been reported in the literature.

Ethnomedicinal Knowledge for Management of Leeches in Assam

“…Hirudinia is dominant aquatic species while terrestrial forms are represented by species of Haemadipsa. Leeches mostly gets attached to the exterior or exposed parts of the body but leech infestation has also been reported frequently from body cavities 1 . Primary complications associated with leech infestation include bites, haemoptysis and haematemesis leading to anemia.…”

Medico-Legal Issues of a Leech Bite in a Premenarcheal Child

“…However, vaginal leech bites in children are commonly reported from the rural parts of north-eastern India (6). Further, an intra-peritoneal leech, which entered through vagina and uterus with visceral perforation in a 2-year-old girl has been reported and the child presented with intra-peritoneal hemorrhage and shock (6). In leech bites, dilated veins and punctured skin with bleeding are seen (2).…”

Leeches — the good, the bad and the wiggly

“…[72][73][74][75][76][77][78][79][80] Invasion of the bladder and uterus have been described, which can be associated with life-threatening anaemia. 73,75,81 A recent dramatic addition to the literature is a case report of a 2-year-old girl in India who presented with intraperitoneal haemorrhage and shock. A leech had gained entry via the vagina, entered the uterus, perforated the fundus of the uterus and thereby entered the peritoneal cavity.…”

“…A leech had gained entry via the vagina, entered the uterus, perforated the fundus of the uterus and thereby entered the peritoneal cavity. 81 The use of the medicinal leech is not without hazard. The gut of Hirudo medicinalis harbours various Aeromonas species, symbiotic gram-negative anaerobic bacteria which are necessary for the digestion of mammalian blood.…”

“…An engorged, detached, and, by then, dead leech measuring 10 cm was found in the blood-filled peritoneal cavity of the child at laparotomy. 81 Failure to locate the leech or leeches (infestations frequently involve multiple leeches) can result in fatal anaemia in situations where access to blood transfusion is limited or unavailable. 64 Vigilance is required to ensure that medicinal leeches do not wander into orifices.…”