Delayed gastric emptying associated with Strongyloides stercoralis infection and pancreatic adenocarcinoma

Abstract

We present a rare case of co-occurrence of Strongyloides stercoralis (S. stercoralis) infection and newly diagnosed pancreatic adenocarcinoma in a 71-year-old female who presented with new-onset jaundice and right upper quadrant abdominal pain. The patient had eosinophilia, recurrent Escherichia coli cholangitis, and a strong family history of jaundice in an endemic region. S. stercoralis larvae were identified on histopathological examination following pancreaticoduodenectomy. Notably, ivermectin treatment attenuated the delayed postoperative gastric emptying that had not responded to conventional management, including nasogastric decompression or drainage of a perigastric collection. While S. stercoralis can cause obstructive jaundice and pancreatic masses, this case highlights the importance of considering parasitic infections in patients from endemic areas or with immunosuppressive conditions who present with abdominal symptoms, particularly to avoid unnecessary interventions and prevent clinical deterioration.