A 17-year-old adolescent boy presented to the emergency department with the chief complaints of dull-aching abdominal pain and constipation for 5 days. He reported frequent consumption of beef, and he denied fever and palpitations. Blood pressure, heart rate, and respiratory rate were within normal limits. On clinical examination, his abdomen was non-tender and non-distended, with no evident palpable mass lesion. A complete blood work-up and chest radiograph were normal. Ultrasonography of the abdomen revealed dilated large bowel loops and an elongated, linear, hypoechoic tubular structure with well-defined echogenic walls in the transverse colon, which was actively moving (Figure 1). The preliminary diagnosis of bowel obstruction due to Taenia saginata (beef tapeworm) was made.
Contrast-enhanced computed tomography (CT) scan revealed a long, linear, hyperdense, non-enhancing structure (˜80–90 cm in length) in the lumen of the transverse colon with the features of bowel obstruction (Figure 2). There was no evidence of bowel necrosis or perforation. With the clinical, sonographic, and CT evidence, the patient was diagnosed with sub-acute bowel obstruction due to T. saginata. The patient was managed conservatively for the bowel obstruction with administration of 100 mg albendazole twice daily for 3 days. The obstruction relieved over a period of 5 days, and patient reported the passage of a large dead worm with his stools after 5 days of treatment (Figure 3).
Taenia infestation is usually a benign parasitic disease, but in rare cases it may lead to surgical emergencies like acute appendicitis, cholecystitis, and, in very rare cases, severe intestinal obstruction.1 Such cases are managed conservatively, and surgical intervention is necessary only in complicated cases. The diagnosis can be made sonographically, on crosssectional imaging, or intra-operatively. The primary method to prevent this infection is to maintain sanitation.2,3
Author contributions: A.A. Wani, M. Ilyas, and S.A. Taley wrote and edited the manuscript and provided the images. I. Robbani edited the manuscript. M. Ilyas is the article guarantor.
Financial disclosure: None to report.
Informed consent was obtained for this case report.
Received January 9, 2018; Accepted March 22, 2018
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2. Sozutek A, Colak T, Dag A, Turkmenoglu O. Colonic anastomosis leakage related to Taenia saginata infestation. Clinics.
3. Karanikas ID, Sakellaridis TE, Alexiou CP, Siaperas PA, Fotopoulos AC, Antsaklis GI. Taenia saginata: A rare cause of bowel obstruction. Trans R Soc Trop Med Hyg.