Magnified Endoscopic Observations of a Living Whipworm.

An asymptomatic 64-year-old man with a colonic polyp was referred to our department. He underwent colonoscopy and a whitish worm was detected in the transverse colon (Picture 1a). Narrow band imaging revealed a whole parasite body (Picture 1b). It could be diagnosed as a whipworm (Trichuris trichiura) due to its specific form (1). Its thin cranial end was invading the mucosa and the opposite caudal end was freely moving. This parasite was confirmed to be a female because of the straight form of its caudal end. The female genitalia (Picture1c: blue arrows) contained many uterine eggs (Picture 1d: red arrows), while the intestine (Picture 1c: green arrows) and esophagus (Picture 1d: yellow arrows) were identified during in vivo magnifying observation. We finally picked up the moving caudal side by biopsy forceps and removed its whole body. A retrieved specimen revealed a worm body with a colonic mucosa (Picture 2: gray arrows). Two sessions of follow-up colonoscopy revealed no further whipworms over a 14-month period without any medication.

Picture 1.

Picture 2.

In Picture 1, a figure of Trichuris trichiura was taken from section 2-7 in ESSENTIALS OF MEDICAL PARASITOLOGY 3rd edit. described by Prof. Isao Tada published by Ishiyaku publishers (2) with the permission of reproduction.

The authors state that they have no Conflict of Interest (COI).