the beef tapeworm ( taenia saginata ) is a common infection of both humans and cattle around the world , especially in areas where beef is eaten . areas where the infection has high prevalence include sub - saharan africa , southeast asia and the middle east . it does occur in the united states , but it is not common due to high sanitation standards . a 47-year - old woman was admitted to our outpatient clinic with a 2-month history of intermittent epigastric pain . her physical examination and the results of routine blood tests were unremarkable . her abdominal x - ray and abdominal ultrasonography was normal . on upper gastroduodenal endoscopy , a live tapeworm was found ( fig.1 ) , extending from the proximal corpus to the third portion of the duodenum , during the endoscopy worm curls around the endoscope as it supposes the scope is the same of its kind . but after the scope hits and pursues the worm , it escapes . in the upper gastroduodenal endoscopy ; there was pale antral mucosa with a shiny surface and mild nodularity , which gastric biopsy revealed antral atrophic gastritis with h. pylori infection . the patient was treated with single dose ( 600 mg ) of praziquantel for t. saginata infestation and we decided to follow up the patient for her chronic atrophic gastritis . after 1 month , she was symptom free and specific exams showed no trace of the parasite . the patient was given a single dose of praziquantel : 15 mg / kg body weight . parasitological controls ( two series of three fecal samples each ) , perfor - med two months later , were negative for proglottides in stool specimens . taenia saginata , or the beef tapeworm , is a parasite of both cattle and humans , which can only reproduce in humans . adult worms residing in the small intestine of a human will lay eggs in the proglottids , which are then released in feces . once proglottids eaten by cattle , the eggs released in the stomach , the digestive enzymes will break down the eggs , allowing the development of oncos - pheres , or zygotes . the zygotes penetrate through the mucous lining of the digestive tract and circulate through the blood stream , where they develop into small larvae . larva will develop into cysts with the muscle tissue and have been found in the liver and the lungs of the intermediate host . in humans , once the stomach acids break down the cysticercus ( cyst containing larva ) , the worm will move into the intestine to evolution . the worm after about two months , reaches an average size of about sixteen feet . the beef tapeworm can reach an average body length between thirteen and thirty - two feet , although some individuals can grow to be thirty - nine feet in length . it can live to be twenty - five years of age within a host ( 1 , 2 ) most taeniasis infections are asymptomatic . when symptoms occur , hosts may experience abdominal pain , headaches , dizziness , weight loss , diarrhea , nausea , constipation , and chronic indigestion . in humans , the tapeworm may cause a blockage in the intestine or cause an allergic reaction when it releases antigens . taeniasis due to t. saginata is relatively common in africa , some parts of eastern europe , the philippines , russia , and latin america . it is rare in the united states , except in places where cattle and people are concentrated and sanitation is poor . in iran , taeniasis is common particularly on western and central regions of the caspian sea ( 3 ) . other reported compli - cations include intestinal obstruction ( 2 ) , obstruction of bile ducts or pancreatic duct ( 4 ) , abnormal vaginal bleeding ( 5 ) and rarely anastomotic leak ( 6 ) or granulomatous gastritis ( 7 ) . taeniasis can be treated using medicines including praziquantel ( 10mg / kg ) ( 9 ) which paralyzes the worm and allows the host to flush it out of the intestines . in order to prevent an infection in humans , it is important to exactly cook beef products . salting or freezing the beef products will also kills the infective larvae within the meat , but other measures , like sanitary disposal of human waste , should be taken . in this patient , t. saginata upward migrated from small intestine to the stomach . because of the high gastric acidity , worm skedaddled but in this case because of ppi use and coexistence h. pylori infection , acidity of stomach ethical issues ( including plagiarism , informed consent , misconduct , data fabrication and/or falsification , double publication and/or submission , redundancy , etc . ) have been completely observed by the authors .
abstracta case of a 40-year - old female , in whom a 6-meter long worm ( taenia saginata ) was found in stomach , is reported here . in this patient , 
 t. saginata upward migration of the worm to the stomach , its rare phenomenon , worm mostly seen in the small intestine . 
 this is mainly because of the high gastric acidity . in this patient 
 , we believe proton pump inhibitor ( ppi ) use caused hypochlorhydria and coexistence h. pylori infection caused chronic atrophic gastritis , which resulted in the retrograde migration of the tapeworm to the stomach in our patient .