A 70-year-old cancer patient who underwent a procedure to investigate blockages in his bile duct was found to have worms in his abdomen.
Five parasitic flatworms were found wriggling in the man’s biliary tract, the series of tubes and ducts that move digestive fluids from the liver to the gut.
Chinese doctors treating the man reported finding worms living in his abdomen when they performed the procedure, which ultimately discovered a tumor in his large intestine.
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 duct 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 they eat raw or undercooked fish
The worms were discovered by happenstance when the man went to the hospital to undergo a cholangioscopy, which involves doctors inserting a camera either through the mouth or the skin to look for problems in the upper abdomen.
He had been previously diagnosed with a type of cancer that develops in the colon (or large intestine) though the worms are thought to be unrelated.
The doctors extracted two of the five worms, which they determined was C. sinensis, a type of worm that appears flat and shaped like a leaf, according to the report in the New England Journal of Medicine.
When a person eats fish and shrimp containing an immature version of the parasite, it travels to the bile duct, the gallbladder, or the liver, where it matures into adult worms measuring 15 to 20 millimeters in length and three to four mm in width – roughly the size of a staple.
Most people who have the worms living in their biliary system – the name for the bile ducts and liver and gallbladder that produce, store, and secrete digestive juices like bile – do not know they have them.
The condition is typically asymptomatic but, if left untreated, can lead to liver inflammation, gallstones, and bile duct cancer.
According to a 2005 report in the journal Emerging Infectious Diseases, at least 600 million people worldwide are at risk of infection with parasitic worms.
However, the risk is highest 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 started the patient on praziquantel, a medication for parasitic infections, as well as chemotherapy for the localized cancer they had found in his intestine.
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