It is unusual to see Taenia saginata located in the stomach. We present a case of living T. saginata incidentally discovered by upper gastrointestinal endoscopy.
A 60-year-old female patient was admitted to the hospital, after ingesting a corrosive substance accidentally. Her physical examination was normal and laboratory values were within normal limits. She had a history of dyspeptic complaints for the past 2 years. She was given proton pump inhibitor therapy and parenteral hydration. Two days later, an endoscopy was performed and it revealed pangastritis and a live tapeworm, extending from corpus through the third portion of duodenum (Figure 1). The tapeworm was grasped by a tripod and removed perorally. It measured 100 cm in length and diagnosed as T. saginata by a parasitologist. After giving a single dose of niclosamid, the scolex and proglottids were seen in the stool.
The beef tapeworm is a common infection of both humans and cattle in Turkey. Its prevalence is unknown. It is estimated that 50 million people worldwide are infested with either T. saginatum, the beef tapeworm, or Taenia solium, the pork tapeworm (Schantz, 1996). The rate of beef tapeworm infestation was as high as 70% because of consumption of undercooked beef, which contained cysticerci (Guo, Zhang, & Guo, 2002). Humans are the only host and are usually infested with a single worm. Patient age and consumption of contaminated water and eating raw liver are the main risk factors for tapeworm infestation (Sun, Zhang, & Du, 2005).
Ingestion of raw or imperfectly cooked beef containing viable cysticercus bovis causes T. saginata infestation. When the cysticercus stage reaches the stomach, proteolytic enzymes start dissolving the capsule. Thereafter, the scolex attaches to the host's intestine, and an adult tapeworm develops. The common clinical manifestations of taeniasis included mild abdominal pain, nausea, change in appetite, and iron deficiency anemia (Barnett, Emder, Day, & Selby, 2007). Most patients remain asymptomatic. The diagnosis of tapeworm infestation is normally based on the microscopic examination of feces and identifying the eggs or proglottids in the stool.
Although T. saginata is mostly seen in the small intestine, upward migration of the worm to the stomach is extremely rare. This may be mainly because of the high gastric acidity. To date, only two reports exist in the literature showing T. saginata infestation in the stomach (Kalkan et al., 2013). Hypochlorhydria as a result of high-dose proton pump inhibitor may be the cause of the retrograde migration of the tapeworm to the stomach in our patient.
In conclusion, this is a common infection in Turkey and the use of high-dose proton pump inhibitors may allow the tapeworm to migrate to the stomach.
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