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Chapter 18

Helminthoma

Considering the huge number of people throughout the world who are infected with intestinal worms, it is surprising that penetration into the bowel wall and formation of a "tumor" are not more common. The majority of intestinal parasites clearly prefer the available food supply and warmth within the gut!

Synonyms

Helminthoma. Pseudotumor. Granulomatous tumor. Pimply gut. Koulkoul. Tumeur de Dapaong. Oesophagostomiasis Sp: Helminthoma. Fr: Helminthoma. Ger: Helminthoma: Wurmknoten.

Definition

A helminthoma is an inflammatory tumor of the bowel wall (usually arising in the muscular layer) which results when an intestinal worm or larva penetrates the wall of the gut, usually the cecum or colon. This definition does not include the intra - or retroperitoneal inflammatory mass or abscess which occurs when a worm (e.g., Ascaris), penetrates completely through the bowel wall.

Geographic Distribution

Theoretically, a helminthoma can occur in any country where infestation of the intestinal tract with worms is common. It has been seen most often in West and East Africa, and parts of South America. One case has been reported from Indonesia: a helminthoma has been recognized in Canada in a patient who had lived for some years in Uganda. Unless a careful search is made for the worm by a pathologist, the cause will go unrecognized.

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