Endoscopic diagnosis of hookworm disease: Report of two cases

Hookworms usually reside in the small intestine, so they are rarely discovered during routine upper gastrointestinal endoscopy (UGIE). We herein report two cases of hookworm infestation diagnosed by UGIE. One of the two cases combined with gastric adenocarcinoma and no parasite ova was detected in stool examination. Ancylostoma duodenale and Necator americanus can infect humans. In Taiwan, N. americanus is prevalent in the north and the east, and A. duodenale is prevalent in the south and the central region. The infection rate in Taiwan is less than 1%. The adult hookworm resides mainly in the jejunum and may be refluxed toward the duodenum and the stomach during bowel contraction. Endoscopically, hookworms are shining red in color, about 10 mm in length, and a couple of female and male worms usually hug together tightly. There is no report to suggest the relation between hookworm infestation and gastric malignancy in the literature.