以肠梗阻为表现的粪类圆线虫1例报道并文献复习

Strongyloides stercoralis infection presenting asintestinal obstruction: A case report with review of literature

目的:了解以肠梗阻为表现的粪类圆线虫的临床特点,以提高诊断及处理水平。方法:对贵阳医学院附院消化内科的1例以肠梗阻为表现的粪类圆线虫的病例进行研究,结合以往国内外相关报告进行分析。结果:男性患者,40岁,以"恶心,呕吐,腹痛,肛门停止排便排气"来就诊,影像学检查发现有肠梗阻征象,内镜下十二指肠、近端空肠多发米粒样增生,经空肠、十二指肠多处活检发现腺上皮内见类圆线虫虫体。予阿苯达唑400mg口服后症状改善,随访至今无异常。结论:以肠梗阻为表现的粪类圆线虫是少见的,详细的病史询问、反复的粪便检查和内镜及病理活检,特别是对类圆线虫病特殊表现的充分认识,可有助于减少误诊和漏诊。

Objective：To investigate the clinical characteristics of strongyloides stercoralis infection presenting as intestinal obstruc- tion, and improving the diagnosis and treatment of clinicians on strongyloides stereoralis infection. Methods： A cases of our hospital which shows the strongyloides stercoralis infection presenting as intestinal obstruction were studied and the similar literature were reviewed. Re- suits：One 40 - year -old male patien,with the main complaints as vomiting, nausea,abdominal pain and rileus, were referred to our hos- pital for further evaluation. Abdominal computed tomography （ CT ） revealed the imaging features of the intestinal obstruction. During gastroduodenoscopy, miliary granulation hyperplasia were seen in duodenum and proximal jejunum of the patient. The diagnosis of strongyloides stercoralis infection was finally confirmed by biopsy of gastrointestinal mucous . Abdominal pain has improved after aral Albendazole 400 mg twice daily for 7 days and no recurrence until now. Conclusion： Strongyloides stercoralis infection presenting as intestinal obstruction representet a rare condition and easily be misdiagnosed. Careful collection of medical history, numerous pokes for stool examination , gastroduodenoseopy and pathological examinations, especially better understanding of the exceptional manifestations , could help to minimize misdiagnosis of sarcoidosis