A 27-Year-Old Lebanese Man with Stomach Perforation and Regurgitation of a Beef Tapeworm (Taenia saginata): A Case Report and Review of the Literature

Abstract

BACKGROUND The global burden of Taenia saginata (T. saginata), the beef tapeworm, includes economic loss, and its pathogenicity is considered mild. T. saginata can infect the human definitive host when people ingest larval cysts from raw or undercooked beef, as cattle are the intermediate host. This report is of a case of gastric perforation and pneumoperitoneum with regurgitation of T. saginata in a 27-year-old Lebanese man, and includes a review of previous cases of gastrointestinal perforation due to T. saginata. CASE REPORT We report a rare case of stomach perforation caused by T. saginata, in which the tapeworm was subsequently expelled orally. A computerized tomography (CT) scan was done, revealing pneumoperitoneum and abdominal fluid, which was consistent with evidence of a perforated hollow viscus. Three days after exploratory laparoscopy, the patient vomited a 3-meter tapeworm and the diagnosis was subsequently made. On the fourth day, a CT scan of the abdomen with oral contrast was performed and showed no leakage. A clear fluid diet was started on the fifth day. The patient was discharged home on the seventh postoperative day in good condition. One week after the discharge, the patient was examined; he was in a good condition and symptoms were completely relieved 1 week after worm expulsion. CONCLUSIONS This report shows that in countries or societies where eating raw beef is common, a diagnosis of infestation with T. saginata should be considered in patients who present with gastrointestinal symptoms.

Figure 1.

Abdominal CT scan before surgery showing free intraabdominal fluid on the posterior side (red arrow) and free extra-peritoneum air on anterior and posterior sides (yellow arrows) caused by abdominal perforation.

Figure 2.

Intraabdominal laparoscopy showing abdominal purulent fluids, fibrin, and pseudomembranes of a patient with gastric perforation and oral expulsion of Taenia saginata.

Figure 3.

Stomach perforation (A) in a 27-year-old Lebanese man with a history of smoking and Taenia saginata infection that was expelled orally (B).