Endoscopic extraction of buski UCTN

A 20−year−old, married, primigravida presented with a history of epigastric dis− comfort, nausea, and vomiting for 3 days. On the day of admission, she gave a his− tory of vomiting up a 3±4−cm, pear− shaped, reddish−brown worm, which Un moved for a few seconds after it was vom− usual ited and then died. On further enquiry, the

patient gave a history of consumption of case vegetables that had been washed in pond water. s and

Upper gastrointestinal endoscopy re− techni vealed a reddish−brown, flat worm stuck in the second part of the (Fig−

Figure 1 Endoscopic view of fasciolopsis bus− cal ure 1, Video 1) The worm was extracted ki stuck in the second part of the duodenum. Figure 2 The endoscopically extracted F. with the help of biopsy forceps under en− notes buski worm was 4 cm long, 2 cm wide, and doscopic guidance. The worm was 4 cm about 0.25 cm thick. long, 2 cm wide, and about 0.25 cm thick, reddish−brown, flattened anteroposteri− thiases, which are strongly dependent on orly, and pear−shaped, with no prominent environmental factors. Fasciolopsis is a References or obvious cephalic cone, and resembled good example of a that the fasciolopsis buski fluke (Figure 2). His− is emerging (or re−emerging) in many 1 Mas−Coma S, Bargues MD, Valero MA. Fa− topathological examination of the speci− countries as a consequence of changes in scioliasis and other −borne trematode zoonoses. Int J Parasitol 2005; 35: 1255 ± men confirmed it as F. buski. Routine in− both environmental and factors 1278 E129 vestigations revealed a normal peripher− [1,2]. Unfortunately, despite control pro− 2 Bhatti HS, Malla N, Mahajan RC, Sehgal R. al−smear eosinophil count. Stool exami− grams, F. buski still remains a public ± a re−emerging infection in nation did not reveal any F. buski eggs. health problem in endemic areas and in Azamgarh (Uttar Pradesh). Indian J Pathol Microbiol 2000; 43: 73±76 The patient was treated with areas where it was once thought to have 3 World Health Organization. Foodborne 25 mg/kg as a single dose. The patient was been controlled [3,4]. trematode infections. Bull WHO 1995a ; 73: asymptomatic and doing well on follow− 397±399 4 up. Though the disease is seen predominantly World Health Organization. Control of food− borne trematode infections. WHO Tech Rep in south−east Asia, the endoscopic image Ser 1995b ; 849: 1±157 To our knowledge, this is the first report of F. buski we have included here may be describing and illustrating the endoscopic of interest to the rest of the world because removal of F. buski from the duodenum of immigration, globalization, and the Corresponding author using forceps. Fasciolopsis and other increased frequency of intercontinental food−borne trematode infections are in− travel. P. M. Rathi, MD This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. cluded in the list of important helmin− Department of Gastroenterology and thiases that have a great impact on hu− Endoscopy_UCTN_Code_CCL_1AB_2AZ_3AZ Hepatology man development. Current changes in Endoscopy_UCTN_Code_TTT_1AO_2AN BYL Charitable Nair Hospital and global weather patterns appear to be in− TN Medical College 1 1 1 creasingly affecting −borne helmin− M. Murugesh , S. Veerendra , S. Madhu , Dr. AL Nair Road 1 2 1 S. Kude , A. D. Amrapurkar , U. U. Rathi , Mumbai Central 1 P. M. Rathi Mumbai 1 Department of Gastroenterology and Maharastra 400 008 Video 1 Hepatology, BYL Nair Charitable India Hospital and TN Medical College, Fax: +91−22−23021168 Upper gastrointestinal endoscopy, showing Mumbai, India Email: [email protected] live, mobile F. buski in the second part of the 2 Department of Pathology, BYL Nair duodenum. The worm was extracted using Charitable Hospital and TN Medical biopsy forceps. College, Mumbai, India. DOI: 10.1055/s−2006−945154

Murugesh M et al. Endoscopic extraction of Fasciolopsis buski ´ Endoscopy 2006; 38: E129