Indian Journal of Pathology and Microbiology
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Year : 2011  |  Volume : 54  |  Issue : 3  |  Page : 663-664
Ryles tube aspiration of tapeworm: An unusual presentation

Department of Pathology, RCSM Government Medical College and CPR Hospital, Kolhapur, Maharashtra, India

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Date of Web Publication20-Sep-2011

How to cite this article:
Acharya AS, Mudholkar VG, Kulkarni AM, Namey RD. Ryles tube aspiration of tapeworm: An unusual presentation. Indian J Pathol Microbiol 2011;54:663-4

How to cite this URL:
Acharya AS, Mudholkar VG, Kulkarni AM, Namey RD. Ryles tube aspiration of tapeworm: An unusual presentation. Indian J Pathol Microbiol [serial online] 2011 [cited 2021 Apr 15];54:663-4. Available from: https://www.ijpmonline.org/text.asp?2011/54/3/663/85148


Tapeworm infestation in human beings can be caused by two species: Taenia solium and Taenia saginata. Improperly disposed human feces and eating of improperly cooked meat are risk factors for transmission of disease. Rarely, the worm may be present in the stomach, leading to potentially infective orogastric secretions. Contamination with these secretions may lead to infection to health professionals, particularly in the highly endemic areas. [1]

A 40-year-old man presented with complaint of acute-onset abdominal pain in right hypochondriac region since 6 hours. He had history of recurrent abdominal pain, nausea, and decreased appetite since 2 months. The patient was a nonvegetarian and routine beef eater. On physical examination, tachycardia and tenderness in right iliac fossa was noted. Laboratory investigations revealed mild anemia (Hemoglobin - 9 gm/dl) and neutrophilic leukocytosis. X-ray of abdomen showed gas under the diaphragm. A provisional diagnosis of intestinal perforation was considered and an emergency laparotomy was planned. Intraoperatively, a perforation was seen in appendix; hence, appendectomy was done. While doing abdominal decompression, Ryle's tube was introduced through nasal route. When suction was applied, it was blocked. On its removal, mucus thread-like structures were noted, which revealed to be the segments of tapeworm [Figure 1].
Figure 1: Aspirated of tapeworm through Ryel's tube

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The appendectomy specimen with pieces of tapeworm was sent for histopathology. On gross, yellowish white segments of tapeworm totally measuring 4.3 m in length were noted. Appendix measured 5 cm in length, showing a perforation of 0.5 cm in diameter on its anterior wall. Microscopy of worm revealed immature and mature proglottids with several lateral branches and calcareous corpuscles [Figure 2]. Appendix showed acute appendicitis with areas of necrosis in the wall. Hence, diagnosis of acute perforative appendicitis with tapeworm infestation was given. Subsequently, stool examination was performed which showed eggs of T. saginata [Figure 3]. The patient was given single dose of praziquantel with a dose of 15 mg/ kg body weight.
Figure 2: Photomicrograph of proglottid of Taenia saginata with several uterine branches and calcareous corpuscles [H and E, ×400]

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Figure 3: Photomicrograph of stool sample showing eggs of Taenia saginata [Iodine preparation]

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T. saginata infection is common in cattle-breeding regions. Areas with highest (i.e., >10%) prevalence rate are central Asia, the Near East, and central and eastern Africa. [2] Symptoms are usually mild and commonly include abdominal pain, anorexia, weight loss, or malaise. [3] Laboratory diagnosis usually involves observing the eggs by microscopy in stool and histological examination of proglottid segment. [3] Ova of Taenia are spherical, yellowish brown, measuring 31 to 34 mm in diameter [Figure 3]. Microscopic appearance of the ova of T. saginata and T. solium are identical, so the diagnosis is made by the recovery of the proglottid segments or scolex. The proglottid of T. solium has 7 to 13 uterine branches, whereas T. saginata has 15 to 20 branches. [3]

The most common serious complication of adult tapeworm infection is appendicitis. How the parasite enters into appendix remains unresolved. Most probably, it attaches to wall of intestine and spread to adjacent organs. It reaches the appendix and produce inflammatory reaction. Taeniasis invades the upper small bowel in human beings. It is very unusual to see this parasite in the stomach. [ 4] Karanikas et al. [5] have described a case of small bowel perforation by T. saginata.

   References Top

1.Ito A, Wandra T, Sato MO, Mamuti W, Xiao N, Sako Y, et al. Towards the international collaboration for detection, surveillance and control of taeniasis/cysticercosis and echinococcosis in Asia and the Pacific. Southeast Asian J Trop Med Public Health 2006;37 Suppl 3:82-90.  Back to cited text no. 1
2.Craig P, Ito A. Intestinal cestodes. Curr Opin Infect Dis 2007;20:524-32.  Back to cited text no. 2
3.Bogitsh BJ, Carter CE, Oeltmann TN. Human Parasitology. 3 rd ed. London: Elsevier Academic Press; 2005. p. 273-7.  Back to cited text no. 3
4.Uygur-Bayramicli O, Yavuzer D, Dolapcioglu C, Sensu S, Tuncer K. Granulomatous gastritis due to Taeniasis. J Clin Gastroenterol 1998;27:351-2.  Back to cited text no. 4
5.Karanikas ID, Sakellaridis TE, Alexiou CP, Siaperas PA, Fotopoulos AC, Antsaklis GI. Taenia saginata: A rare cause of bowel obstruction. Trans R Soc Trop Med Hyg 2007;101:527-8.  Back to cited text no. 5

Correspondence Address:
Abhijit S Acharya
Department of Pathology, RCSM Government Medical College and CPR Hospital Campus, Kolhapur, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0377-4929.85148

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  [Figure 1], [Figure 2], [Figure 3]


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