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The Old Endoscopy Quiz (and Answer) of the Month
June 2000

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Question:


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This middleaged man was examined becaese of pain in his left lower abdomen. In the sigmoid colon he had a typical diverticular disease probably explaining the symtoms. There was another finding however. These pictures are from the ascending part of the colon, and the third picture from the caecum. What is this finding perhaps not quite common in this age group?

Answer

Pinworm (Enterobius Vermicularis)

Slideshow:


Pinworm in the Sigmoid Colon


Three pinworms seen by a videoendscope in the colon ascendens

Pinworm, Enterobius vermicularis, also called oxyuris vermicularis, is an intestinal roundworm endemic in both temperate and tropical regions and common especially in schoolage children. It is especially common in group living conditions. The pinworm can be found in the caecum and colon. Anal pruritus is the most common symtom, but the infection can be associated with abdominal pain. The adult female pinworm is about 10 millimeters long, the male pinworm is much smaller. The female worm lays eggs in the perianal region, and the worm is transmitted from person to person via the infected persons hands, or by bedclothes. Enterobius vermicularis can be treated with several antihelminthic drugs, e.g. pyrantel pamoate, pyrvinium pamoate or mebendazole.

Correct answers were emailed by:

annabella, vinha del mar, chile


Turkey
Tahir Buran, İzmir, Turkey - Many Greetings to Izmir, where I spent two unforgettable weeks as an exchange student in 1968!
Abdon Guerra, San Antonio, CHILE
Kathy Jones, Humble, USA
IGNACIO HANNA, GUAYAQUIL, ECUADOR
Antonio Sia, Patrocinio(MG), Brasil
Karen Stone, Rapid City, sd
Peeter Kõiva, Tartu, Estonia
Tomislav Brkic, MD, Zagreb, Croatia
Peter Kübler, P-7555 Cercal, Portugal
Josep Roure, Girona, Spain
Ann Raadik, Keila, Estonia
Enrique Bolona, Guayaquil, Ecuador
Gabriel Dimofte, Iasi, Romania
me mosese, witsieshoek, rep of south africa
Francesco Di Stefano, Sant'Agata li Battiati (CT), Italy

Comments:

Intestinal worms. I had a patient reffered for an atypical abdominal symptomatology and I found a huge ascaris lumbricoides in the cecum. First thought was an artefact produced by a vegetable fiber, but it start ... moving. I believe the situation is generated by the use of isoosmolar colonic lavage which brings those worms in the colon. Best wishes

pinworms--thank you :)


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