Neelam Khetpal, MD1, Adalberto Gonzalez, MD2 1Cleveland Clinic Florida, Weston, FL; 2Cleveland Clinic Florida, Boca Raton, FL Introduction: Despite being the most common heminthic infection in the United States and Western Europe, Enterobious vermicularis (pinworm) is rarely seen during colonoscopy. We present a case of pinworm found incidentally during a screening colonoscopy and its management.
Case Description/
Methods: A 51 year old Male underwent a colonoscopy for average-risk colorectal cancer screening. During the colonoscopy, he was noted to have several living, moving worms throughout the colon with the majority dwelling in the cecum. He was otherwise healthy and was asymptomatic. He reports being born and raised in south Florida, United States. He denied recent domestic or international travel, camping. The worm was retrieved with a cold biopsy forceps, and the fluid from his colon was suctioned and worms were captured using a suction polyp trap. The worm was identified as Enterobius vermicularis. He was treated with albendazole 400 mg by mouth, one dose on day 0 and a second dose on day 14. He was also instructed to have his household contacts treated due to high transmission rates within households. Discussion: Enterobius vermicularis is the most common helminthic infection in the United States and Western Europe, with a peak prevalence in school-age children. Most infectious are asymptomatic but may cause perianal itching. The larvae in ingested eggs typically hatch in the in the jejunum, develop in the ileum, and reside in the cecum. Simultaneous treatment of the entire household and caregivers is warranted regardless of symptoms given high transmission rates within households. The main medications used are albendazole, mebendazole, or pyrantel pamoate. The are no estimates of the prevalence of pinworms found during routine colonoscopy.
Figure: Figure 1. Small worms in the cecum near the appendiceal orifice.
Disclosures: Neelam Khetpal indicated no relevant financial relationships. Adalberto Gonzalez indicated no relevant financial relationships.
Neelam Khetpal, MD1, Adalberto Gonzalez, MD2. P1362 - Pinworm Found During Screening Colonoscopy, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
