Ars Technica – This case began innocently enough: a 40-year-old man arrived at an emergency room complaining of fatigue that had progressively gotten worse over a three-month period.
Doctors ran blood tests that determined the man was anemic. They also found that he had high levels of white blood cells called eosinophils, which usually indicate an infection or some other type of disease.
Last, they noted elevated alkaline phosphatase levels, which can be a sign of liver trouble.
When the doctors took abdominal scans, they noted anomalies in the man’s bile ducts—the bodily piping that moves bile around and connects the liver, gallbladder, pancreas, and small intestine.
Next in their investigation, they decided to perform an endoscopic retrograde cholangiopancreatography (ERCP), which is a diagnostic procedure that probes and visualizes problems in the ducts around the small intestines, gallbladder, and pancreas.
In the procedure, doctors thread a long, flexible tube with a light source and camera down a patient’s throat, through the stomach, and into the small intestines. Through the tube, doctors inject dye to highlight the ducts on X-rays.
With the camera on, doctors immediately found the source of the problem: Large flatworms were seen spilling out of the bile duct into the small intestine.
They caught one on video and reported it this week in the New England Journal of Medicine.
These are—as the name suggests—common flatworm parasites … Read more.