CRCM  Vol.3 No.3 , March 2014
Tape Worm Induced Recurrent Pancreatitis: A Case Report and Review of Literature
ABSTRACT

Recurrent idiopathic pancreatitis is an uncommon disease. We are presenting a case of Taenia saginata causing pancreatitis, which is rare in the literature. A 40 years old female was admitted to our hospital with complaints of epigastric pain for 6 months, radiating to the back, combined with nausea, vomiting and significant weight loss. On examination, she looked ill, vitally stable, afebrile, not jaundiced, and her abdomen was soft, lax with moderate epigastric tenderness, no distention and positive bowel sounds. Her workup showed serum amylase of 1367 U/L, Liver function test, Calcium and Triglycerides were all within normal ranges. Abdominal Ultrasound showed homogeneous bulky pancreas with dilated pancreatic duct. CT abdomen confirmed the diagnosis of pancreatitis with no evidence of biliary stones. An upper gastrointestinal endoscope revealed diffuse gastritis with small haital hernia. She was treated conservatively as a case of idiopathic acute pancreatitis and later was discharged in good condition. One month later, she was admitted again with similar symptoms and attacks of diarrhea. Investigations showed amylase of 139 U/L, abdominal Ultrasound was negative for biliary stones. CT showed a prominent pancreatic duct and thickened duodenum. Oesophagogastrodudenoscopy was repeated to evaluate the cause of the pain. This interestingly revealed a tapeworm (Taenia saginata) in the second part of the duodenum, adjacent to ampulla of Vater. The patient received Mebendazole 100 mg PO BID for three days and later was discharged home. At 4 weeks follow up, she was asymptomatic and her stool analysis was negative.


Cite this paper
Altaf, A. , Alnabulsi, R. , Alsubahi, T. and Zaidi, N. (2014) Tape Worm Induced Recurrent Pancreatitis: A Case Report and Review of Literature. Case Reports in Clinical Medicine, 3, 175-180. doi: 10.4236/crcm.2014.33042.
References
[1]   Sarles, H., Sarles, J.C., Camatte, R., Muratore, R., Gaini, M., Guien, C., Pastor, J. and Le Roy, F. (1965) Observations on 205 Confirmed Cases of Acute Pancreatitis, Recurring Pancreatitis, and Chronic Pancreatitis. Gut, 6, 545-559.
http://dx.doi.org/10.1136/gut.6.6.545

[2]   Steinberg, W. and Tenner, S. (1994) Acute Pancreatitis. The New England Journal of Medicine, 330, 1198-1210.
http://dx.doi.org/10.1056/NEJM199404283301706

[3]   Lee, S.P., Nicholls, J.F. and Park, H.Z. (1992) Biliary Sludge as a Cause of Acute Pancreatitis. The New England Journal of Medicine, 326, 589-593. http://dx.doi.org/10.1056/NEJM199202273260902

[4]   Crompton, D.W. (1999) How Much Human Helminthiasis Is There in the World? Journal of Parasitology, 85, 397-403.
http://dx.doi.org/10.2307/3285768

[5]   Bordon, L.M. (1992) Intestinal Obstruction due to Taenia saginata Infection: A Case Report. The Journal of Tropical Medicine and Hygiene, 95, 352-353.

[6]   Karanikas, I.D., Sakellaridis, T.E., Alexiou, C.P., Siaperas, P.A., Fotopoulos, A.C. and Antsaklis, G.I. (2007) Taenia saginata: A Rare Cause of Bowel Obstruction. Transactions of the Royal Society of Tropical Medicine and Hygiene, 101, 527-528, http://dx.doi.org/10.1016/j.trstmh.2006.07.004

[7]   Ozbek, A., Guzel, C., Babacan, M. and Ozbek, E. (1999). An Infestation Due to a Taenia saginata with an Atypical Localization. American Journal of Gastroenterology, 94, 1712-1713.
http://dx.doi.org/10.1111/j.1572-0241.1999.01712.x

[8]   Daou, R., Achram, M., Abousalbi, M. and Dannaoui, M. (1998). Acute Acalculous Cholecystitis Due to Taenia saginata. Chirurgie, 123, 195-197. http://dx.doi.org/10.1016/S0001-4001(98)80106-2

[9]   Yellin, A.E. and Donovan, A.J. (1981) Biliary Lithiasis and Helminthiasis. The American Journal of Surgery, 142, 128-136. http://dx.doi.org/10.1016/S0002-9610(81)80022-0

[10]   King, C.H. (2000). Cestodes (Tapeworms). In: Mandell, G.L., Bennett, J.E. and Dolin, R., Eds., Principles and Practice of Infectious Diseases, 5th Edition, Churchill Livingstone, Philadelphia, 2956-2964.

[11]   Liu, Y.M., Bair, M.J., Chang, W.H., Lin, S.C. and Chan, Y.J. (2005) Acute Pancreatitis Caused by Tapeworm in the Biliary Tract. American Journal of Tropical Medicine and Hygiene, 73, 377-380.

[12]   Sheikh, M., Sheikh, I., Ali, I. and Reshi, F. (2008) Nasal Expulsion of Taenia saginata: A Rare Route of Expulsion. The Internet Journal of Surgery, 16, Article 7.

[13]   Benedict, E.B. (1926) Taenia saginata in the Gall Bladder. The Journal of the American Medical Association, 87, 1917.
http://dx.doi.org/10.1001/jama.1926.92680230001012

[14]   Talice, R.V. and Perez-Moreira, L. (1954) Localization of Taenia saginata in the Gallbladder. Archivos Uruguayos Medicina, Cirugia y Especialidades, 44, 261-269.

[15]   Kim, Y.H., Chi, G.J. and Cho, S.-Y. (1981) A Case of Taenia saginata Infection Involving Gallbladder and Common Bile Duct. Korean Journal of Parasitology, 19, 167-172. http://dx.doi.org/10.3347/kjp.1981.19.2.167

[16]   Daou, R., Achram, M., Abousalbi, M. and Dannaoui, M. (1998) Acute Acalculous Cholecystitis Due to Taenia saginata. Chirurgie, 123, 195-197. http://dx.doi.org/10.1016/S0001-4001(98)80106-2

[17]   Khuroo, M.S., Zargar, S.A., Mahajan, R., Bhat, R.L. and Jovid, G. (1987) Sonographic Appearances in Biliary Ascariasis. Gastroenterology, 93, 267-272.

[18]   Khuroo, M.S. (1996) Ascariasis. Gastroenterology Clinics of North America, 25, 553-577.
http://dx.doi.org/10.1016/S0889-8553(05)70263-6

[19]   Jung-Cook, H. (2012) Pharmacokinetic Variability of Anthelmintics: Implications for the Treatment of Neurocysticercosis. Expert Review of Clinical Pharmacology, 5, 21-30. http://dx.doi.org/10.1586/ecp.11.72

 
 
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