CASE 179: CHRONIC DIARRHEA and CAPSULE ENDOSCOPY, Dr PHẠM CHÍ TOÀN, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Clinical history=

Female, 91 years old, Nha be district. For 3 months: watery diarrhea without blood (over 10 times/day), no abdominal pain. Treated by many doctors and medical centers, but diarrhea did not stop.

Tropical disease hospital admission: failed treatment after a month and transmitted to Binh dan hospital.

v  Lab test: normal, Abdominal US,  CT scan: normal, UGE : normal, Rectosigmoid endoscopy: normal. Stool test: negative, suggestion : capsule endoscopy.

v  Capsule Endoscopy= Many worms with the appearance of Ankylostoma in jejunum and ileum and inflammed mucosa of small bowel.

Diagnosis=Enteritis due to parasite (maybe Ankylostoma duodenale).  Internet : some case reports like this.

Treatment=

Suggestion : stop using all kinds of drugs including antibiotics, start with Zentel 2 tablets a day/ 3 days. Diarrhea improves in getting down : 10 times and 6 times and 4 times and 2 times. Discharge. Suggestion: repeated Zentel after a week, now normal stool.

Conclusion=

Few case reports, besides anemia, acute or chronic diarrhea sometimes happens. Easy and simple treatment.

But the worm name should be proved by ELISA test for Ankylostoma.