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Logo of bmjcrInstructions for authorsCurrent ToCBMJ Case Reports
BMJ Case Rep. 2010; 2010: bcr0520103023.
Published online Aug 31, 2010. doi:  10.1136/bcr.05.2010.3023
PMCID: PMC3030100
Novel diagnostic procedure
Capsule endoscopy is a feasible procedure for identifying a Diphyllobothrium nihonkaiense infection and determining the indications for vermifuge treatment
Yoshiki Nomura,1 Mikihiro Fujiya,1 Takahiro Ito,1 Katuyoshi Ando,1 Ryuji Sugiyama,1 Toshie Nata,1 Nobuhiro Ueno,1 Shin Kashima,1 Chisato Ishikawa,1 Yuhei Inaba,1 Kentaro Moriichi,1 Kotaro Okamoto,1 Tetsuya Yanagida,2 Akira Ito,2 Katsuya Ikuta,1 Jiro Watari,3 Yusuke Mizukami,1 and Yutaka Kohgo1
1Department of Medicine, Division of Gastroenterology and Hematology/Oncology, Asahikawa Medical College, Asahikawa, Japan
2Department of Parasitology, Asahikawa Medical College, Asahikawa, Japan
3Department of Internal Medicine, Division of Upper Gastroenterology, Hyogo College of Medicine, Nishinomiya, Japan
Correspondence to Mikihiro Fujiya, fjym/at/
Diphyllobothrium is a member of Cestoda family, which is the largest parasite of humans. The diagnosis of diphyllobothriasis is based on the detection of eggs in the stool. Because the remainder of the scolex causes a relapse in diphyllobothriasis, the scolex must be completely discharged to cure the parasite infection. However, the scolex or forefront of the Diphyllobothrium is difficult to detect with gastroduodenoscopy and colonoscopy, because most Diphyllobothrium attach to the jejunal wall. In the present case, capsule endoscopy detected proglottids as well as forefront of the parasite at jejunum. Based on the results of capsule endoscopy, the patient underwent additional vermifuge (anthelminthic) treatment to cure the diphyllobothriasis and discharged a worm measuring 3 m in length with a scolex. Capsule endoscopy is a practical option to determine whether additional vermifuge treatment is required through the detection of the proglottids as well as a scolex or forefront of the parasite.
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