Giardia lamblia trophozoites in gastric biopsies.

To assess the prevalence of gastric giardiasis in gastric biopsies of patients with carcinoma stomach and in patients taking treatment for duodenal ulcer. Gastric biopsy specimens from 54 patients of carcinoma stomach and 100 antral biopsies from patients taking treatment for duodenal ulcer were included in the study. Sections were stained with haematoxylin and eosin, methylene blue and May Grunwald-Giemsa stains and examined for presence of Giardia lamblia trophozoites. Eight out of 54 (14.9%) biopsies of gastric carcinoma patients harboured trophozoites of Giardia lamblia. Associated H. pylori infection was present in all biopsies (8/8; 100%). Atrophy and intestinal metaplasia was present in 62.5% (5/8) and 25% (2/8) cases respectively. Sections from seven out of 35 patients (20%) taking treatment for duodenal ulcer showed presence of G. lamblia. H. pylori infection, gastritis and atrophy were found in 85.7% (6/7), 71.4% (5/7) and 28.6% (2/7) cases respectively. First gastric biopsy in these patients was negative for G. lamblia but 2nd and 3rd biopsies were positive. A careful search for G. lamblia trophozoites should be made while examining the gastric biopsies, especially in patients with carcinoma stomach, intestinal metaplasia, atrophic gastritis and those taking treatment for duodenal ulcer. This may help in indirect diagnosis of clinically unsuspected cases of intestinal giardiasis and may explain persistence of vague upper gastrointestinal tract (UGIT) symptoms despite clearance of H. pylori in patients on anti-ulcer therapy.

Inter-relationship between Gasterophilus larvae and the horse's gastric and duodenal wall with special reference to penetration.

The degree of penetration into the stomach and duodenum of the horse by bot fly larvae, Gasterophilus intestinalis (De Geer) and G. nasalis (Linnaeus) (Diptera : Gasterophilidae) was evaluated. Evidence of larval perforation of the stomach or duodenum was not found on gross inspection. Palpation of the intact stomach and duodenum was not effective in establishing the existence of Gasterophilus larvae within the organs. Findings suggest that larvae of both species produce an ulcer of similar depth within the gastrointestinal wall. The ulcer depth produced by larvae did not correlate with the normal, unaffected thickness of the particular stomach or duodenum. Tissue proliferation beneath ulcers of the stomach and duodenum was not correlated with the depth of the ulcer. Proliferation of the tissue beneath the ulcers of the stomach generally exceeded that found under duodenal ulcers. Gastric wall beneath the G. intestinalis ulcer frequently attained a thickness equal to or greater than the normal stomach wall. Histopathological examinations below the ulcer revealed intense fibrosis. Duodenal thickness below the G. nasalis ulcer was typically less than normal and resulted in an attenuated wall. Histopathological analysis of the affected duodenum revealed severe loss of submucosal glands in a sharply demarcated area below and surrounding the lesion. Fibrosis of the underlying lamina propria mucosae and tunica submucosa was appreciable but failed to restore the original thickness of the duodenal wall. Host tissue response and moderation of the parasite' s behavior reduce the chances of direct perforation of the gastrointestinal tissue.