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An exotic case of duodenal obstruction
Ana Rita Franco, Rui Mendo, André Mascarenhas, Catarina O'neill, Raquel Mendes, Pedro C. Figueiredo, Cristina Chagas
Centro Hospitalar Lisboa Ocidental - Hospital Egas Moniz
A 28-year-old female from Guinea-Bissau living in Portugal for 6 years presented with intense epigastric pain and food intolerance for 2 weeks.
Esophagogastroduodenoscopy showed a phytobezoar in the second duodenal portion. Upon its removal, a linear ulcer was found which extended to the third duodenal portion, ending in a pinhole ulcerated stricture. Enteral-MRI showed gastroduodenal dilatation followed by a circumferential narrowing of the third duodenal portion. Duodenal mucosa biopsies showed eggs and larvae of Strongyloides stercoralis. The diagnosis of duodenal obstruction due to S. stercoralis infectious duodenitis was made.<br />The patient was treated with ivermectin with rapid symptomatic improvement.
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