Endoscopic and Clinical Characteristics of Gastrointestinal Parasite Infections

Lee, Won Hyun; Yoo, Seung Seok; Kim, Hyun Jin; Kim, Tae Hyo; Lee, Ok Jae

Abstract

BACKGROUND/AIMS: Although the overall infection rate of infection with parasites has decreased, the rate of food-mediated infection with parasites has not declined. This study was conducted to define the various endoscopic and clinical characteristics of gastrointestinal (GI) parasite infections diagnosed endoscopically.
METHODS
We reviewed retrospectively the medical records including the endoscopic reports of 27 patients with GI parasite infections diagnosed endoscopically at University Hospital from January 1993 through September 2006.
RESULTS
Among 27 patients with a GI parasite infection, 66.7% were female and food-mediated parasite infections including anisakiasis accounted for 77.8% of all of the infections. Soil-mediated parasites were still detected. Extremely rare cases of echinostomiasis and diphyllobothriasis were also identified. Abdominal pain was most frequent symptom (48.1%) and even intestinal or biliary obstructions were seen. The most common endoscopic finding was a visible worm, and various findings including the presence of a pseudotumor were observed. The median period from symptom onset to endoscopy was 15 days for anisakiasis with a pseudotumor compared to 1 day for anisakiasis without a pseudotumor.
CONCLUSIONS
Endoscopy revealed the presence of various GI parasite infections as well as the presence of anisakiasis, a food-mediated parasitic disease. Various clinical and endoscopic features were seen, including GI bleeding, obstruction, and a pseudotumor. Therefore, a thorough endoscopic examination is required promptly together with detailed history taking concerning the consumption of raw fish.