World Journal of Surgery

, Volume 36, Issue 9, pp 2090–2092 | Cite as

Leech Infestation in Children Through Body Orifices: Experience in a Hospital in Bangladesh

  • Md. Jafrul HannanEmail author
  • Md. Mozammel Hoque



Bangladesh harbors many leeches in its vast wetlands. Leeches have a tendency to enter through body orifices with potentially life-threatening consequences. Literature search revealed inadequate description of clinical manifestations and treatment of leech infestations in children. We describe our experience with leech infestations in children.


Between January 1, 2004 and December 31, 2010, 17 cases of leech infestation through body orifices in children were managed. This is a retrospective study on age, sex, route of leech entry, investigation and treatment, and outcome.


Age ranged from 4.5 to 11 years (mean 6.4 ± 1.8) and females accounted for more than 70 %. The orifices of leech entry include urethra, vagina, and rectum. Leeches could be found in eight cases. Two boys with leeches in the urinary bladder needed suprapubic removal. Leeches were retrieved from the vagina under general anesthesia in three cases, and on three occasions leeches came out from the vagina after normal saline instillation. In nine cases with different routes of entry where leech was not found, instillation of normal saline was sufficient to stop bleeding. Fifteen cases presented with bleeding and transfusion was required in five cases with Hb% <7 gm/dl.


Leech infestation through lower body orifices is common in children of rural Bangladesh. Prompt diagnosis is of paramount importance, and application of normal saline is effective in most cases. Sometimes surgical intervention is required.


Urinary Bladder Medicinal Leech Common Salt Body Orifice Suprapubic Bladder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Abdelgabar AM, Bhowmick BK (2003) The return of the leech. Int J Clin Pract 57(2):103–105PubMedGoogle Scholar
  2. 2.
    Ganguly BB, Sinha AK, Adhikari S (1988) Introduction to biology of animals. Central Educational Enterprise, Kolkata, pp 23–39Google Scholar
  3. 3.
    Hamid MS, Mohd Nor GR (1996) Severe urological complication of leech bite in the tropics. Br J Urol 77:164–165PubMedCrossRefGoogle Scholar
  4. 4.
    Ghosh D, Saha S, Das S, Samanta N, Konar H (2002) Leech in urinary bladder. J Indian Assoc Pediatr Surg 7(1):46–49Google Scholar
  5. 5.
    Mukherjee G (1974) Unusual foreign body causing hematuria. J Indian Med Assoc 63:284–285PubMedGoogle Scholar
  6. 6.
    Chen WC, Chien CY, Yang CH et al (2010) Nasal leech infestation: report of seven leeches and literature review. Eur Arch Otorhinolaryngol 267:1225–1229PubMedCrossRefGoogle Scholar
  7. 7.
    Krüger C, Malleyeck I, Olsen OE (2004) Aquatic leech infestation: a rare cause of severe anaemia in an adolescent Tanzanian girl. Eur J Pediatr 163:297–299PubMedCrossRefGoogle Scholar
  8. 8.
    Lewis G, Coombes A (2006) Adult ocular leech infestation. Eye 20(3):391–392PubMedCrossRefGoogle Scholar
  9. 9.
    Saha S, Saha I (1977) Unusual foreign body causing bleeding per urethra. J Indian Med Assoc 69:286–287PubMedGoogle Scholar
  10. 10.
    Hailemariam B (2005) Post menopausal vaginal bleeding due to vaginal wall leech infestation. Ethiop Med J 33(3):183–185Google Scholar
  11. 11.
    Raj SM, Radzi M, Tee MH (2000) Severe rectal bleeding due to leech bite. Am J Gastroenterol 95(6):1607PubMedCrossRefGoogle Scholar
  12. 12.
    Hannan MJ, Haque AU, Hoque MM (2011) Cystoscopy-assisted percutaneous removal of impacted urethral stone: a case report. J Laparoendosc Adv Surg Tech doi: 10.1089/lap.2011.0120 [Epub Ahead of Print]

Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  1. 1.Pediatric SurgeryChattagram Maa-O-Shishu Hospital Medical CollegeChittagongBangladesh

Personalised recommendations