A 70-year-old cancer patient who underwent a procedure to investigate blockages in his bile ducts turned out to have worms in his stomach.
Five parasitic flatworms were found wriggling in the man's bile ducts, the series of tubes and ducts that carry digestive fluids from the liver to the intestines.
Chinese doctors who treated the man reported finding worms in his abdomen when they performed the procedure, ultimately discovering a tumor in his colon.
The type of worm was Clonorchis sinensis, native to East Asia. These flatworms, which are not rare in certain areas of East Asia, typically infect a person's bile ducts after eating raw or undercooked freshwater fish or shrimp.
The worms, identified as Clonorchis sinensis, are endemic to Asia and typically infect a person when he eats raw or undercooked fish.
The worms were discovered by chance when the man went to the hospital to undergo a cholangioscopy, in which doctors insert a camera through the mouth or skin to look for problems in the upper abdomen.
He had previously been diagnosed with a form of cancer that develops in the colon (or colon), although the worms are thought to be unrelated.
The doctors extracted two of the five worms, which they determined were C. sinensis, a type of worm that looks flat and is shaped like a leaf, according to the report in the New England Journal of Medicine.
When a person eats fish and shrimp that contain an immature version of the parasite, it travels to the bile ducts, gallbladder or liver, where it grows into adult worms 15 to 20 millimeters long and three to four millimeters wide. about the size of a staple.
Most people whose worms live in their bile ducts – the name for the bile ducts, liver and gallbladder that produce, store and secrete digestive fluids such as bile – don't know they have them.
The condition is usually asymptomatic but, if left untreated, can lead to liver inflammation, gallstones and bile duct cancer.
According to a 2005 report in the magazine Emerging infectious diseasesAt least 600 million people worldwide are at risk of becoming infected with parasitic worms.
However, the risk is greatest in China, Korea and Vietnam, where the worms are endemic and cultural culinary practices often include eating raw or undercooked fish.
The doctors were able to remove the worms. They gave the patient praziquantel, a drug for parasitic infections, and chemotherapy for the localized cancer they found in his intestine.