In a rare case, a 14-year-old boy, whose 22 litres of blood was sucked by hookworms in his small intestine since the last two years, was cured through a deworming therapy at a city hospital here.

The diagnosis was possible only after hospital recommended the rarely-used vitamin capsule-size endoscopy.According to doctors, the boy was referred to Sir Ganga Ram Hospital (SRGH) in August last year with complaints of the passage of blood in his stool."The child was suffering from iron deficiency anaemia for the last two years. He was being managed with repeated blood transfusions and received 50 units (22 litres) of blood transfusions in the last two years," said Anil Arora, Chairperson of Gasreroenterology Department at SRGH.

Arora said the patient's diagnosis could not be established despite various repeated tests including esophagogastroduodenoscopy (EGD), colonoscopy and radiographic studies of the intestine.The patient's haemoglobin was low at 5.86. As the problem persisted and there was gastrointestinal bleeding, the doctor decided to go for the rarely-used Capsule endoscopy.Capsule endoscopy is a procedure that uses a tiny wireless camera to take pictures of the digestive tract. A capsule endoscopy camera sits inside a vitamin-size capsule that the patient has to swallow.

Calling the findings "shocking", Arora said: "We could see multiple hookworms buried in the small intestine and were seen actively sucking blood with dancing movements."Sucked blood could be seen in the cavity of hookworms, giving red colour to them. White coloured hookworms who had not yet sucked blood were seen lying quiet in the small bowel."

"After treatment, the child recovered and his haemoglobin increased to 11 gm/dl," said Arora, describing the health condition of the patient.The rare medical case has been published in the latest edition of Journal of Infectious Diseases and Therapy."Conventionally, hookworm infestation is found commonly in Asian population. The manifestation of hookworms can be prevented by avoiding barefoot walking and maintenance of food hygiene," he said.