Gastrointestinal bleeding due to whipworm (Trichuris trichiura) infestation: a case report.

Severe whipworm infestation, an exceedingly uncommon cause of gastrointestinal bleeding, has not been reported in Taiwan. The reported case concerns a 59-year-old female who had suffered from abdominal pain and passage of tarry stool for several days. Esophagogastroduodenoscopy was performed, and several roundworms were seen in the second portion of duodenum. After removal, the characteristic appearance of Trichuris trichiura was apparent. After exploratory laparotomy for intractable bloody stool, the result of operative findings and pathological reports also confirmed our diagnosis. This is a case presented of massive gastrointestinal bleeding in which the cause of bleeding was diagnosed before operation to be whipworm infestation by endoscopic examination. The clinical and pathologic characteristics of the trichuriasis are described, with a brief review and discussion.

Intracranial epidermoid cysts.

Intracranial epidermoid cysts are rare and constitute only 0%-8% of all intracranial tumors. Ten cases with verified pathology were observed during a 3-year period, comprising 4% of our brain tumors. There were two rare intracerebral cysts and one hourglass-shaped lesion involving the middle and posterior fossa. One patient presented with suprasellar retrochiasmative lesion, the remaining patients had C-P angle epidermoid cysts. Patients were aged between 18 and 58 years (averaging 41 years) with a long history of progressive neurological deficit (average 4.3 years). There were 6 women and 4 men. The clinical symptoms differed according to the location of the lesions. High-resolution computerized tomography was the main diagnostic procedure for these lesions. Typically, they revealed a hypodense and non-enhanced mass lesion. Calcification was seen in three of our patients. Total gross resection of cysts should be attempted whenever the cystic wall allows, especially for patients with unbearable trigeminal neuralgia. The post-operative results for this benign tumor were excellent in most patients.