A CASE-REPORT OF COLONIC ILEUS DUE TO EOSINOPHILIC NODULAR LESIONS CAUSED BY GNATHOSTOMA-DOLORESI INFECTION

Gnathostomiasis is primarily a disease of the skin characterized as cr eeping eruption or mobile erythema. However, larval Gnathostoma someti mes migrate into an unexpected site to elicit serious illness. Here we describe a case of colonic ileus caused by Gnathostoma doloresi. The patient was a 57-year-old man living in Miyazaki Prefecture, Japan, wh ich is known as an area endemic for this parasite. One week after havi ng eaten a few slices of the flesh of a snake (Agkistrodon halys), he developed severe abdominal pain. An abdominal radiograph revealed mult iple gas-fluid levels with a distended bowel of an inverted U shape. A barium enema revealed a tumor in the ascending colon near the hepatic flexure that was surgically removed by simple colonic resection. An o blique section of a parasite surrounded by massive infiltration of eos inophils was found by postoperative histopathologic examination. The e ntire body of the advanced third-stage larva of G. doloresi was dissec ted from a specimen-embedded paraffin block.