A rare case of intestinal obstruction due to ascariasis in Niš, south Serbia

Abstract

<jats:title>Abstract</jats:title><jats:p>Ascariasis 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.</jats:p>

Avicenna’s View on the Etiologies of Intestinal Obstruction

“…According to studies, worm infestation is one of the causes of intestinal obstruction, especially in children. Roundworms (ascariasis) are the commonest cause of bowel obstruction ( 26 - 31 ). Therefore, as the first differential diagnosis, round worm obstruction should be considered in any intestinal obstruction in an endemic area ( 32 ).…”

Ascariasis: A common disease with uncommon presentation in a resource limited setting. A case report

“…While many infections are asymptomatic, some individuals may experience symptoms such as diarrhea, loss of appetite, weakness, stomach pain, changes in bowel habits, weight loss, and in rare cases, the expulsion of worms through the mouth or rectum. Severe cases can result in intestinal blockages characterized by abdominal bloating, the presence of an abdominal mass, tenderness, or pain [9] .…”

“…The causes of Ascariasis-related intestinal obstructions can be attributed to the formation of large worm masses that mechanically obstruct the intestine, worm masses acting as lead points for intussusception, or the release of neurotoxins causing contractions and inflammation in the small intestine, leading to obstruction [9] . Along with clinical signs and symptoms, imaging techniques play a vital role in diagnosing Ascariasis-related intestinal obstruction.…”

When Diagnosis Curls a Little: Partial Bowel Obstruction Due to Ascaris. L in a Young Man

“…However, massive immigration and refuging, especially in recent years, might modify the previous epidemiology of infections. 15 …”