Ascariasis—Its Complications, Unusual Presentations and Surgical Approaches

Di, Schuster; Rp, Belin; Jc, Parker; Ja, Burke; Jz, Jona

doi:10.1097/00007611-197702000-00020

Cited by 10 publications

(3 citation statements)

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“…We have seen granulomas in patients who had a history of operations for traumatic intestinal perforations [7]. Similar reports have appeared in the literature [10,22].…”

Section: Peritoneal Granulomas: 9 Casessupporting

confidence: 55%

“…Migration has been reported with increased frequency following common bile duct sphincterotomy [19]. The condition is more frequent in children; it is occasionally reported in the Western nations [10,11]. We have seen Ascaris obstructing nasogastric tubes, exiting by the tract or the lumen of abdominal drains, being excreted through the umbilicus (omphalomesenteric duct), the nose, and even through the ear!…”

Section: Migration Of Ascaris To the Biliary Tree: 19 Patientsmentioning

confidence: 91%

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Surgical complications of ascariasis

Ochoa

1991

World j. surg.

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Over the past 25 years (1963-1988), a total of 311 children under 12 years of age were admitted to the Pediatric Surgical Service of the San Vicente de Paúl University Hospital, Medellín, Colombia, with complications resulting from infection with Entamoeba histolytica or Ascaris lumbricoides. In this group, the abdominal complications produced by ascariasis numbered 145, and included intestinal obstruction (n = 107), perforation of the appendix (n = 10), and migration of the parasite to the biliary tree or to the peritoneal cavity (n = 28). Evaluation of the living conditions of a significant subgroup of our patients confirms that intestinal parasitism is an endemic condition prevailing in nations that exhibit deep social and economic imbalance, where large sectors of the population remain deprived of the basic services of education, health, housing, and recreation. Massive infestation in children may give rise to grave complications that demand expert surgical care. Third World surgeons practicing in general hospitals that take care of patients of low economic capacity are usually familiar with the diagnosis and management of this pathology; surgeons who practice in the industrialized nations will only occasionally face such problems. The greater mobility of today's societies and the rather massive migrations that take place in current times have resulted in an increasing incidence of these entities in the hospital populations of the large urban centers of these nations. It is for the surgeons practicing in such centers that the information presented herein may be of greater value.

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“…We have seen granulomas in patients who had a history of operations for traumatic intestinal perforations [7]. Similar reports have appeared in the literature [10,22].…”

Section: Peritoneal Granulomas: 9 Casessupporting

confidence: 55%

Section: Migration Of Ascaris To the Biliary Tree: 19 Patientsmentioning

confidence: 91%

Surgical complications of ascariasis

Ochoa

1991

World j. surg.

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“…These abscesses were drained under antihelmintic and antibiotic medication, and the resolution was good. In adults, on the other hand, the presentation is more often a biliary infection [16].…”

Section: Discussionmentioning

confidence: 99%

Ascaris‐induced Liver Abscess

et al. 1999

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The prevalence, symptomatology, and outcome of Ascaris-induced liver abscess was studied prospectively in Kashmir, India, which is an endemic area of ascariasis, from December 1987 to December 1997. Of 510 patients with liver abscess admitted during this period, 74 had biliary ascariasis as the cause (14.51%). Of these 74 patients, 11 had intact ascaridae (live or dead) within the abscess. Six patients had a single abscess, and five had multiple abscesses. Seven patients had associated worms in the bile ducts. Ultrasonography was the main diagnostic procedure used. Ten patients were diagnosed based on clinical and ultrasound findings, and one was diagnosed during laparotomy. Most of the patients were young (age range 3-40 years) with a mean age of 17.20 years. Seven were females, and four were males. Ten patients underwent surgery; nine recovered completely, and one died postoperatively due to septicemia. Another patient died as well: a young child who presented late, was in refractory septic shock following suppurative cholangitis and liver abscess, and could not be taken for surgery. The mortality thus was 9.9%. Liver abscess following invasion of intrahepatic biliary radicles by ascaridae through the ampulla is an unusual complication of an otherwise common disease in Kashmir Valley, affecting children and young adults. The outcome depends on early diagnosis and surgical drainage of the abscess with extraction of worms from the ducts.

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