Hookworms are recognised as a cause of iron-deficiency anaemia in endemic areas. They are, however, often not considered in the differential diagnosis of overt gastrointestinal bleeding. We report the endoscopic diagnosis of hookworms as the cause of gastrointestinal bleeding in three patients, two of whom had frank haemorrhage with one presenting in hypovolemic shock. Hookworm infestation is an important treatable cause of gastrointestinal bleeding in tropical countries.
BrookerSBethonyJHotezPJ. Human hookworm infection in the 21st century. Adv Parasitol2004; 58: 197–288.
2.
SharmaBCBhasinDKBhattiHS. Gastrointestinal bleeding due to worm infestation, with negative upper gastrointestinal endoscopy findings: impact of enteroscopy. Endoscopy2000; 32: 314–316.
3.
SharmaVSharmaA. A capsule or a tablet. Clin Gastroenterol Hepatol2011; 9: 804–804.
4.
Del ValleAJonesBFHarrisonLM. Isolation and molecular cloning of a secreted hookworm platelet inhibitor from adult Ancylostoma caninum. Mol Biochem Parasitol2003; 129: 167–177.
5.
GhoshalUCVenkitaramananAVermaA. Hookworm infestation is not an uncommon cause of obscure occult and overt gastrointestinal bleeding in an endemic area: A study using capsule endoscopy. Indian J Gastroenterol2015; 34: 463–467.
6.
GersonLBFidlerJLCaveDR. ACG Clinical Guideline: Diagnosis and management of small bowel bleeding. Am J Gastroenterol2015; 110: 1265–1287.
7.
GunjanDSharmaVRanaSS. Small bowel bleeding: a comprehensive review. Gastroenterol Rep (Oxf)2014; 2: 262–275.
8.
ThomasVHarishKTonyJ. Hookworm infection: does it cause overt intestinal bleeding?Gastrointest Endosc2006; 63: 736–736.