鉤頭虫

Acanthocephaliasis（Corynosomiasis）

要旨●患者は70歳代，男性．201X年1月に，腹痛を主訴に近医を受診し，腸閉塞の疑いで当院に紹介され入院した．原因診断目的で経肛門的小腸内視鏡検査を施し，回腸に吸着する5mm程度の寄生虫を認めた．内視鏡的にこれを除去したが，約1年後，同患者が血便を主訴に再受診し，空腸から再び4隻の寄生虫を摘出した．虫体はすべてCorynosoma属に同定された．本属の人体感染は北海道で相次いでおり，急性腹症の診察時に注意を要する．

　A 7X-year-old male was referred to our hospital with suspected ileus after consulting a local doctor for abdominal pain in January 201X. Transanal small bowel endoscopy was performed to diagnose the cause of the pain, and a white foreign body（approximately 5mm）was detected piercing the ileum. As it was a parasite, we removed it ; however, the patient underwent medical examination again 1 year later because of complaints of melena. Subsequently, four worms were endoscopically removed from the jejunum. All the removed worms were identical to acanthocephalans of the genus Corynosoma. Because infection due to this parasite has recently been emerging in Hokkaido, Japan, this should be considered in the diagnosis of patients presenting with acute abdomen.