January 26, 2017
A 48-year-old man presented with a 2-month history of abdominal discomfort and lethargy. Physical examination revealed pallor, and results from laboratory studies showed mild anemia (hemoglobin level, 9.2 g per deciliter [normal, 12 to 15 g per deciliter]). Colonoscopy revealed a proglottid from a tapeworm in the rectosigmoid colon, and gastroduodenoscopy identified its location in the proximal duodenum, extending distally (Video 1). A gastroscope and forceps were used to identify the tip of the tapeworm, and the tapeworm was extracted through the patient’s mouth (Panel A and Video 2). The tapeworm measured 188 cm in length (Panel B) and was identified as Taenia solium, also called the pork tapeworm. Endoscopic removal is not essential for management of T. solium infection; standard medical therapy is to administer either praziquantel or albendazole. In the case of this patient, after removal of the whole tapeworm, a dose of praziquantel was administered. One month after the extraction procedure, the patient remained asymptomatic.
Cyriac A. Philips, M.D.
Amrish Sahney, M.D.
Institute of Liver and Biliary Sciences, New Delhi, India