Elderly case of duodenal ascariasis removed by endoscopy: A caution for ascariasis as a revived infection in Japan

A case of duodenal ascariasis in an 89-year-old woman is presented. Gastrointestinal endoscopy was performed for chest pain. During this procedure a cord-like structure was found incidentally in the second part of the duodenum; it was removed and identified as a female specimen of Ascaris lumbricoides. Recently ascariasis in Japan has revived because fresh vegetables without agricultural chemicals are now common. Careful observation of the entire duodenum at gastrointestinal endoscopy is required in elderly patients, especially those in poor general condition as in the present case, because complications of ascariasis such as acute pancreatitis, acute cholangitis, and liver abscess may be more critical for them.