When surgeons dug into a man’s groin to repair a painless lump, they made the unexpected discovery of a 10-inch-long (26 cm) live worm lodged in his abdomen. To add to the strangeness, the man told the surgeons that this had happened to him before, according to a case report in the New England Journal of Medicine.
The 71-year-old opted to undergo surgery to repair the lump, which was an inguinal hernia. These types of bulges are quite common, especially in older men, and occur when a small amount of abdominal contents, such as fat or a bit of intestine, slips through a gap or weak spot in the muscles and tissues of the abdominal wall. This bodily leakage creates an external lump that, in some cases, can be painful and uncomfortable. If the contents of the lump become stuck and pinched, it can even create a life-threatening situation called a strangulated hernia. But in other cases, the escaped entrails are painless and loose and can be temporarily put back into place with a simple, gentle massage.
Most people with inguinal hernias will need surgery at some point to repair their weak abdominal wall. But, for older men who have no pain or discomfort, doctors may suggest watchful waiting, delaying surgery until the need is clear. This was the case of the man. But he opted to repair the inguinal hernia, which was on his right side.
Surgeons noted that the man appeared to be in good health before surgery and reported no symptoms other than the painless lump. His blood tests also seemed normal and gave no indication of anything wrong, such as an elevated white blood cell count that could indicate a parasitic infection. The surgeons opted for a laparoscopic procedure, making small incisions to insert tools to strengthen the abdominal wall.
As they worked, they noticed something whitish and fibrous. It was wedged between the bladder and the pubic bone. Surgeons used forceps to grab a loop that poked into view and then needed multiple tugs to gently slide out the rest. When they carefully removed it in its entirety and unfolded it, they recognized it as a 26 cm long (10.2 in) tapeworm. He was still alive, sliding and writhing on the operating table. An image of the surgical finding is here.
