From Big Medical Encyclopedia

EZOFAGOSTOMOZ (oesophagostomo-sis) — the helminthosis from group of nematodoses which is characterized by damage of intestines, generally large intestine.

In literature it is described apprx. 30 cases E. person: in Africa (Nigeria, Uganda, Ghana, Ethiopia), Indonesia N to South America (Brazil).

Etiology. Activators E. ezofagostoma are. At the person parasitizing of ezofagosty three types is established: Oesophago-stomum (Conoweberia) aculeatum (Linstow, 1879); Oesophagostomum (Conoweberia) bifurcum (Creplin, 1849); O. (Ihlea) of stephanostomum (Stossich, 1904). However it is not excluded that parasitizing at the person and nek-ry other helminths of this sort is possible. Owners ezofagosty are monkeys.

Males of Oesophagostomum (Ihlea) stephanostomum have

length of 18 — 24 mm, the maximum width — 0,68 — 0,74 mm, females — respectively 18 — 30 and 0,74 — 0,9 mm. Puberal O.' sizes aculeatum and O. bifurcum are approximately identical and fluctuate in the following limits: length of males

is 8 — 13 mm, width is 0,31 — 0,41 mm, length of females is 11,5 — 19 mm, width is 0,38 — 0,54 mm. Eggs oval with a thin cover, length of their 0,051 — 0,08 mm, width — 0,029 — 0,043 mm.

A life cycle of helminths of the sort Oesophagostomum is well studied at page - x. animals and are not enough — at monkeys and the person. After allocation to the environment of eggs with excrements of owners approximately in 2 days at t ° 20 — 24 ° them leave larvae, to-rye in process of growth and development fade twice and turn into invasive larvae. The invasive larva gets to an organism of the owner through a mouth and then is implemented into a mucous membrane 1 Russian cabbage soup a podslpzisty basis of a large intestine. In 48 hours around masks - granulematozny fabric forms — the small knot is formed. The parasite fades once again then leaves in a gleam of a large intestine where there is the fourth molt and further development of helminth. In 15 — 20 days helminths reach puberty, and the female begins to lay eggs. Perhaps also infection with invasive larvae through skin. The term of development of larvae ezofagosty in tissues of the person is not known. At the person of a larva can not leave in a gleam of a large intestine; quite often they get under a serous cover where are encapsulated, creating parasitic cysts, in to-rykh can reach puberty. Longevity of helminth in a human body is not known.

Epidemiologists I. A source of an invasion are monkeys. The person can catch E. at consumption of fruit and vegetables with the larvae which are on them ezofagosty, through the water containing larvae and also through dirty hands.

The pathogeny of a disease is caused by a sensitization of an organism products of exchange of helminth, to-rye are especially intensively allocated during a molt of the larvae parasitizing in a wall of a large intestine. Therefore during this period E. proceeds most hard (a so-called nodular disease). Due to the drift the migrating larvae ezofagosty in a wall of a large intestine of pathogenic microflora suppuration of small knots is possible. Mechanical it toksiko-is also scarlet-lergicheskoye influence of helminth and the microflora accompanying it is followed by an inflammation of a wall of a large intestine, dysfunction of intestines.

Pathological anatomy E. at the person it is studied insufficiently. Parasitic cysts are localized under a serous cover of a large intestine, have serovatozhelty color, 1,5 cm have a diameter. On a section the central cavity filled with yellowish-green putreform weight in a cut is defined there is a helminth of yellowish or golden-brown color. In case of death of helminth in a cyst fibrous fabric develops, calcification is possible.

Clinical to and r t and - N and. Distinguish two periods of a disease: early, larvaceous, in time to-rogo there is implementation of larvae in a wall of intestines, and late, Yim Gying and l n y — the period of a pas ra z it and a ro-vaniye of helminth - in a gleam of a large intestine. The loss of appetite, weakness, apathy, abdominal pains, diarrhea, weight loss is characteristic of the larvaceous period. In the pmapshalny period the disease quite often proceeds without clinical manifestations, diarrhea is possible. At localization of parasitic cysts under a serous cover at thin patients it is palpatorno possible to determine dense tumorous educations by the course of a large intestine.

The most frequent complications E. obturation or invagination of a large intestine (see Impassability of intestines) at the level of localization of parasitic cysts are.

The diagnosis can be established only in the imaginal period of a disease. It is based preferential on data epidemiol. the anamnesis (stay in the area where infection E is possible.) and researches of excrements on existence yapts helminth. Differential diagnosis is carried out with tumors of intestines (see) also it is based on results of a helmintologic research. In especially hard cases resort to a diagnostic laparotomy and a research of contents of the cysts which are localized under a serous cover of a large intestine on availability of helminth.

Treatment is carried out by thiabendazole (mintezoly), usually on

25 mg/kg by 2 times a day within 2 — 3 days in a complex with giposensi-biliziruyushchy therapy and vitamins. A daily dose of thiabendazole for adult 1 g. A contraindication to purpose of this drug is pregnancy. In cases of invagination or obturation of a large intestine, sharply progressing lose of weight in the presence of multiple parasitic cysts operational treatment for the purpose of their removal is recommended.

The forecast is favorable, in complicated with l teaching yakh — la of a gopra I tny only on condition of an operative measure.

Prevention — washing of hands before food, careful washing of fruit, berries, greens with the subsequent washing by their hot water (t ° 60 ° above), the use of a decontaminated water.

Bibliography: Parasitology and invasive diseases of farm animals, under the editorship of K. I. Abuladze, M., 1975: Priest island and T. I. Bases of a nematodologiya, t. 7. Strongiloide of animals and person, Tri-honematidy, page 268, M., 1958; Barro w-cloughH. CromeL. Oesophagosto-miasis in man, Trop. geogr. Med., v. 31, p. 133, 1979; JacquesJ. E. a. Lynch J. B. Massive oesophagostomiasis of the colon, Gut, v. 5, p. 80, 1964.

B. A. Astafyev.