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

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the Quiz Page

Question:


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This patient was examined because of a severe anaemia. In these pictures from the caecum and proximal ascending part of the colon, two causes of anaemia can be found. The first - and the most important - one is naturally the tumour seen opposite to the valvula Bauhini. But the other reason of anaemia, what is it?

Answer

A tapeworm in the ascending colon with its head probably somewhere in the distal small bowel. We thouht that this would be a fish tapeworm (Diphyllobotrium latum), because every text book knows that this is a worm very common in Finland - we have not found one in soon twenty years. However, many of the answers have suggested a beef tapeworm. Is there any out there who really know for sure - please send an email and we will include any comments in this page.

Correct answers were emailed by participiants in 18 countries in 5 continents:

... it is a small world we are living in!
    Peeter Kõiva, Tartu Estonia
    IGNACIO HANNA J, GUAYAQUIL, ECUADOR
    Kathy Jones, Humble, USA
    Lars G Salde, Lund, Sweden

Pigeon Rocks, Beirut, Lebanon
    Zahreddine Radwan, Beirut, Lebanon
    Abdon Guerra, San Antonio, CHILE
    Hermann Teroll, Valencia, Spain
    Dokas Stefanos, Thessaloniki Greece
    eulalio muñoz quintana, Mexico City, Mexico d.f.
    Antonio Sia, Patrocinio(MG), Brazil
    Ann Raadik, Keila, Estonia
    Dr. Poschmann, Hanau, Germany
    MOSESE M E, QWAQWA, SOUTH AFRICA
    Josep Roure, Girona, Spain
    Dimofte Gabriel, Iasi, Romania
    Hans Tanghöj, Eskilstuna, Sweden
    HIAM, KHARTOUM, SUDAN
    Jose, Villavicencio, Colombia
    ROBERTO CASSO, Sto. Dgo, Rep. Dominican
    Rogério Godinho, Barreiro, PORTUGAL
    Nathalie McMIllan, Hull, Canada
    FERNANDO KON JARA, PORTOVIEJO, ECUADOR
    John, Provo, UT

    Comments:

    In fact the first cause of anemia is the iron deficiency produced by the blood loss by the tumor, the second cause is the worm that it is present, sometimes this parasites are dependant of vitamine B12 so can produce anemia.

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