AbstractAscariasis is a helminthic infection of global distribution, and intestinal obstruction is its most common gastrointestinal complication. This is a case of a 7-year-old boy admitted to Pediatric Surgery because of intestinal obstruction caused by ascariasis. On admission, the patient presented with colicky abdominal pain, bile-stained vomiting and meteorism. On physical examination, the patient was thin, pale, and dehydrated. An abdominal examination showed distention and diffuse tenderness. After admission, the patient had fecal vomiting and expulsion of worms through the mouth. Laboratory-test results showed leucocytosis, eosinophilia, hypoalbuminaemia, and hypochloremia. Abdominal radiographs and ultrasound studies were indicative of small-bowel obstruction due to roundworms, which led to the performance of an exploratory laparotomy. On bowel exploration, an intraluminal mass, 10 by 6 cm in diameter, consisting of roundworms in the middle third of the ileum was found. A longitudinal enterotomy was performed, and the worms were meticulously extracted manually. Postoperatively, broad-spectrum antibiotics and antihelminthic drugs were administered. Our case of intestinal obstruction caused by ascariasis is the first to be reported in Serbia, according to the Serbian literature.
We performed a retrospective analysis of all records of children with ingested foreign bodies presented to Clinical Center of Niš Pediatric Clinic and Pediatric Surgery and Orthopedics Clinic in the period from January 2014 to June 2017. The most commonly detected foreign bodies were: metal coins (7) followed by hairclips (2), metal key (1), trichobezoar (1) magnets (1) button battery (1) and zipper puller (1). Regarding anatomical location, foreign bodies were most frequently found in stomach (in 11 patients) followed by esophagus (in 2 patients) and jejunum (in 1 patient). In the majority of our patients (7) foreign bodies passed out of gastrointestinal tract spontaneously. Endoscopic foreign body removal was performed in 5 cases while surgery as a sole therapeutic action was done in 1 patient. In one child multiple magnets were removed from the stomach performing both endoscopic and surgical interventions. Teamwork of a gastroenterologist and a surgeon is crucial for optimizing therapeutic options for each individual patient. Public awareness of this problem and education of parents should be increased to a higher level in order to prevent cases of foreign bodies ingestion in children.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.