Strongyloides stercoralis:: A rare cause of obstructive duodenal stenosis

Background: Strongyloidiasis is a rare helminthic infection in Europe, and it may cause duodenal obstruction. Methods: We report a patient who was admitted to our Medical Department with nausea and repeated vomiting since 10 years until food intake became impossible. Subsequent investigations revealed a duodenal obstruction at the upper third of the duodenum, as well as enterocolitis of the terminal ileum with eosinophils dispersed throughout the mucosa. Since food intake was still not possible after treatment with a course of i.v. PPI and prokinetic applications, we decided to perform a resection of the upper duodenum with Y-Roux reconstruction. Results: The histopathological examination of the resected specimen revealed strongyloidiasis. Conclusion: Parasite infections such as strongyloidiasis represent a rare differential diagnosis of duodenal obstruction especially if patients originate from endemic regions. Copyright (C) 2008 S. Karger AG, Basel.