A Case of Hematesis and Severe Anemia due to Leech Biting

Background & Objective: Leech biting rarely causes bleeding in Alimentray and Respiratory systems and in genital. Leech saliva contains strong anticoagulant materials. The most important one is Hirudine, which by inhibiting the thrombine causes dysfunction in coagulation. Normally leech is taken by contaminated water and goes inside mouth and nose. The most common places of leech bite are the mucuses of nose and nasopharynx which causes epistraxis and respiratory distress. In rare cases it may stick to profunda muscuses like esophagus and Trachea and causes hematemsis, hemoptysis and respiratory distress.

Case report: In Agust 2003 a three and half year old girl from a village in Ilam state was referred with hematsis and due to severe anemia she was transfused packed cell and platelet. The endoscopy showed that leech bite on the esophagus wall was the cause of bleeding. Bleeding stopped when one leech came out through vomiting and another one by froceps.

Discussion: In regions where people use natural water, the presence of leech is a possibility. Therefore people should be informed about the dangers of leech and recommended to use filtered and clean water.