Abstract
Tere are many reports of the disease produced by infection with Strongyloides stercoralis. In these reports. various clinical features including symptoms, laboratory findings or certain specific findings in roentgenological examination of the gastrointestinal tract are described.But none of these have mentioned the findings of the endoscopic observation of duodenum and jejunum. Recently we experienced 4 cases of severe infection with Strongyloides stercoralis. Duodenofiberscopic examination by using FGDS (Machida) revealed serious duodenitis and jejunitis in all of the cases. Mucosal edema, whitish discoloration and turbidity of the mucosa with much of dirty mucus were noticed instead of normal velvety mucosal pattern. In some cases, ulceration or erosions with occaional bleeding were present. Especially in one of the cases, operated on the stomach by means of Billroth-II because of the duodenal ulcer, many shallow ulcers with slight stenosis were displayed in the jejunum. Bringing the f iberscope to the mucosa disclosed that tips of the many of the villi became thickened and club-shaped in all of the cases. These findings were very similar to macroscopic findings of the small intestine in the autopsy cases. Endoscopic biopsy of the jejunal mucosa in the gastrectomized case revealed severe infestation with many larvae as well as adult worms. These findings disappeared in a short period after taking a vermif uge, Thiabendazol. The features revealed by duodenof iberscopic examinations in 4 cases of serious strongyloidiasis are very interesting with regards to the diagnostics of small intestine by use of endoscope. We expect that in the near future it will become possible to observe endos-copically and take biopsy specimens under direct vision throughout the entire small intestine.
