A 14-year-old boy was brought to Sir Ganga Ram Hospital six months ago with two episodes of passage of blood in stools. The child was suffering from anaemia for the last two years and was being treated with repeated blood transfusions and had received 50 units (22 litres) of blood transfusions in the same time period.
“His diagnosis could not be established despite various tests including esophago-gastroduodenoscopy (EGD), colonoscopy and radiographic studies of intestines done earlier. More tests at our centre also came back normal. His haemoglobin was low at 5.86 gm/dl,” explained Dr. Anil Arora, chairperson, Department of Gastroenterology, Sir Ganga Ram Hospital.
In view of the boy’s obscure (unknown origin) gastrointestinal bleeding (OGIB), doctors conducted Capsule Endoscopy, a procedure where a tiny wireless camera takes pictures of your digestive tract. A capsule endoscopy camera sits inside a vitamin-size capsule which is swallowed.
“ The results shocked us. We could see multiple hookworms buried in the small intestine and were seen actively sucking blood. Sucked blood could be seen in the cavity of hookworms, giving the worms a red colour. White-coloured hookworms who had not yet sucked blood were seen lying quiet in the small bowel. After treatment, the child recovered and his haemoglobin increased to 11 gm/dl,” said Dr. Arora.
Case published
The case was published recently by Department of Gastroenterology, Sir Ganga Ram Hospital in the Journal of Infectious Diseases and Therapy .
“The case showed that hookworm manifestation, if not diagnosed timely, can not only lead to their multiplication but also immense blood loss and complications,” the doctors noted.
“Manifestation of hookworms can be prevented by avoiding walking barefoot and maintaining food hygiene,” said Dr. Arora.
