S VATANSEVER, O CENGİZ, F. ASLAN, G YÖRÜK, B. ÜNSAL, Behlül BAYDAR

Enteroskopide tespit edilen tenia saginata

Tenia saginata, sanitasyonun iyi olmadığı, az pişmiş veya çiğ et tüketiminin fazla olduğu bölgelerde yaygın bir endo- parazittir. Enteroskopi, endoskopi ve kolonoskopi ile ulaşılamayan gastrointestinal sistemin ince barsak kısmını görüntüleyebilen yeni geliştirilmiş bir tanı yöntemidir. Olgumuz, 44 yaşında erkek hasta, yaklaşık bir aydır süren göbek çevresinde lokalize karın ağrısı ile başvurdu. Yüzde 10’dan fazla kilo kaybı, alt ekstremitelerinde miyalji yakınmaları nedeni ile yapılan batın ultrasonografisinde barsak ansları arasında minimal serbest sıvı saptanması üzerine ileri tetkik için kliniğimize yatırıldı. Fizik muayene, laboratuvar ve radyodiagnostik tüm testleri normal bulundu. İnce barsak kökenli patolojileri ayırt etmek için yapılan enteroskopide jejunumun 100. cm’sinden başlayıp lümen boyunca uzanım gösteren T. saginata görüldü. Hastaya niklozamid verilerek taburcu edildi. Sonuç olarak, klinik ve laboratuvar testleri sırasında saptanamayan, ancak enteroskopi sırasında rastlantısal olarak tanı konulan, karın ağrısı ve kilo kaybının etyolojisinde, tenya varlığının da düşünülmesi gerektiğini hatırlatırız.

Tenia saginata diagnosed during enteroscopy

Tenia saginata is a common endo-parasite that is common in areas where uncooked or underdone fresh meat are over consumed. Enteroscopy is a newly improved investigation method which displays intestine which cannot be reached by endoscopy or colonoscopy. Our case is a 44-year-old male, who applied with abdominal pain around umblicus which had been ongoing for a month. He was hospitalized for further investigation in determining reasons for more than 10% loss in weight, myalgia in lower extremities and free ascite between intestinal segments in ultrasonography. Physical examination, laboratory and radiologic tests were all within normal limits. Tenia saginata was seen incidentally in jejenum during enteroscopy. The patient was discharged under niclosamide treatment. As a result, in the ethiology of abdominal pain and weight loss, the existence of Tenia, which was not diagnosed with laboratory and radiologic tests, however was incidentally diagnosed during enteroscopy, should be kept in mind.

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1. Garcia HH, Gonzalez AE. Taenia solium cysticercosis. Lancet 2003; 362: 547-556.
2. Yamamoto H, Kita H, Sunada K, et al. Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small- intestinal diseases. Clin Gastroenterol Hepatol 2004; 2: 1010-1016.
3. World Health Organisation (1992) Report of the WHO working group on clinical medicine and chemotherapy of alveolar and cystic echinococcosis. WHO/CDS/VPH/93.118
4. Lees W, Nightingale J, Brown D, et al. Outbreak of Cysticercus bovis (Taenia saginata) in feedlot cattle in Alberta. Can Vet J 2002; 43: 227-228,
5. Payne J. Taenia infestation of the vermiform appendix. Med J Aust 1970; 57: 768-769.
6. Song EK, Kim IH, Lee SO. Unusual manifestations of Taenia solium infestation. J Gastroenterol 2004; 39: 288-291.
7. Salaria M, Parmar V, Kochar S, Mehta S. Eosinophilia, pleural effusion and cysticercosis—unknown association? Indian Pediatr 2001; 38: 671-674.
8. Yamamoto H, Sekine Y, Sato Y, et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc 2001; 53: 216-220.
9. May A, Nachbar L, Ell C. Double-balloon enteroscopy (push-and-pull enteroscopy) of the small bowel: feasibility and diagnostic and therapeutic yield in patients with suspected small bowel diseases. Gastrointest Endosc 2005; 62: 62-70.
10. Deplazes P, Eckert J, Pawlowski ZS, et al. An enzyme-linked immunosorbent assay for diagnostic detection of Taenia saginata copro-antigens in humans.Trans R Soc Trop Med Hyg. 1991; 85: 391-396.
11. Allan JC, Avila G, Garcia Noval J, et al. Immunodiagnosis of taeniasis by coproantigen detection. Parasitology. 1990;101:473-477.
12. Machnicka B, Dziemian E, Zwierz C. Detection of Taenia saginata antigens in faeces by ELISA. Appl Parasitol. 1996: 37: 106-110.