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Dr. C. Mathias, assistant physician in the hospital Santa Casa of São Paulo, who has performed about 550 duodenal intubations during the last three years, found giardiasis in 22 cases, or about 4 per cent. In 16 patients of this group, the parasites were found both in the duodenum and in the gallbladder; in the remaining 6 patients the infestation was localized in the gallbladder alone. In 13 patients of the first subgroup (of 16 patients) giardiasis complicated a lithiasic or inflammatory process of the gallbladder, as proved by the clinical examination, cholecystography and the Meltzer-Lyon test. In these cases the symptoms of giardiasis were overshadowed by those of inflammation and lithiasis. In the 3 remaining cases of this subgroup there were symptoms of gastro-intestinal dyspepsia characterized by fulness of the epigastrium and right hypochondrium, alternating attacks of diarrhea and constipation, coated tongue, lack of appetite and slight
RIO DE JANEIRO. JAMA. 1931;96(23):1967–1968. doi:10.1001/jama.1931.02720490047023
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