Varun Jain, Sherrie R White, Deepak Sharma and Andrey Iliev
Strongyloides Stercoralis is a nematode and infection from it is common in Sub-Saharan and South East Asia continent. It is mostly asymptomatic but if it presents, then is usually seen with vague gastrointestinal complaints. Small bowel obstruction is a poorly recognized and possibly underreported complication. We hereby present a case of partial small bowel obstruction from S. Stercoralis. A 35 year old man from Africa presented with one year history of post prandial nausea, abdominal bloating and bilious vomiting along with significant weight loss. His abdomen X ray and CT scan were consistent with partial proximal bowel obstruction. He presented to different hospitals and was treated for his symptoms, but a definite diagnosis could not be made. We performed upper endoscopy and biopsy which was consistent with S. Stercoralis infection. He was treated aggressively with Ivermectin and Albendazole until his stool cultures became negative for infectious larvae. He was followed up after 3 and 6 months with complete resolution of symptoms. We conclude that, since S. Stercoralis is an uncommon etiology for proximal bowel obstruction, high index of suspicion should be exercised in patients presenting as above and recent travel to areas endemic for S. Stercoralis.
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