Sonographic diagnosis of Ascaris lumbricoides infestation as a cause of intestinal obstruction

Mehta, Vinod; Goyal, Sunder; Pandit, Sanjay; Mittal, Amit; Aggarwal, Amit

doi:10.1007/s12098-010-0114-1

Cited by 13 publications

(14 citation statements)

References 2 publications

(1 reference statement)

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“…These findings were picked up in our patient only on the review scan. 16,17 Majority of the patients respond to conservative management with iv fluids and nasogastric aspiration for 48-72hrs. 15 Though albendazole or mebendazole are the first line drugs, pyrantel palmoate is the drug of choice in pregnancy.…”

Section: Discussionmentioning

confidence: 99%

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Potentially Grave Gastro-Intestinal Tract Problems in Pregnancy - A Challenge to the Obstetrician!

Sathyanarayana¹,

Amudha²,

Srinivas³

2016

jebmh

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Acute surgical pathology may be overlooked in pregnancy. Despite advances in medical technology, preoperative diagnosis of potentially grave pathologies of the gastrointestinal tract (GIT) is often delayed due to overlap with symptoms of pregnancy non-specific elevation of some laboratory parameters due to pregnancy and a dilemma for obstetricians and surgeons in ordering radiological imaging modalities given the risk associated with fetal exposure to ionizing radiation and contrast. AIMS The aim of this study is to analyse the cases of gastrointestinal tract problems encountered in pregnancy so that increasing awareness can be created among obstetricians. This is important because early diagnosis and timely intervention can significantly improve maternal and fetal outcome in these cases. SETTINGS AND DESIGN There is a retrospective case study of potentially grave GIT problems encountered at Vanivilas hospital, Bangalore, a tertiary referral institute wherein the clinical presentation was confounded by pregnancy. MATERIALS AND METHODS All the included cases were analysed for age of the patient, pre-existing gastrointestinal tract disorders, gestational age at diagnosis, maternal and fetal outcome. RESULTS A total of 8 cases of GIT problems in pregnancy were studied. Though acute appendicitis is the most common cause of GIT emergency in pregnancy as quoted in literature 5, we did not encounter any case of acute appendicitis in pregnancy in the study period. Other conditions which were encountered were small bowel obstruction, stomach and bowel perforation and bleeding oesophageal varices. Whilst few of the conditions could be managed conservatively without harm to the pregnancy, others required a laparotomy and reparative procedures. Delay in diagnosis and intervention proved to be fatal in some of these women. CONCLUSIONS Knowledge about potentially grave gastrointestinal tract problems during pregnancy, high index of clinical suspicion, prompt diagnosis (including radiological investigations) and timely intervention including laparotomy, when indicated will help to reduce maternal and foetal morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

“…Bowel resection and anastomosis is only required if there is perforation or gangrene. 15,16 Perforations of the bowel due to typhoid fever are still common in the developing countries. Other causes of bowel perforation include diverticulitis, appendicitis, trauma, ulcerative colitis etc.…”

Section: Discussionmentioning

confidence: 99%

Potentially Grave Gastro-Intestinal Tract Problems in Pregnancy - A Challenge to the Obstetrician!

Sathyanarayana¹,

Amudha²,

Srinivas³

2016

jebmh

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“…An A lumbricoides infestation could present colecistitis, cholangitis, pancreatitis, intestinal volvulus, intussusception, appendicitis, intestinal necrosis, or IO, the latter being the more frequent. 7 – 9 Complications can be observed in all ages but children between 3 and 5 years are especially susceptible, caused by large number of worms in a diminished intestinal diameter and the ileocecal valve. A lumbricoides.…”

Section: Discussionmentioning

confidence: 99%

“… 11 Ultrasound will be useful in identifying thick echogenic strip with central anechoic tube; multiple linear or curvilinear echogenic strips without acoustic shadowing; “railway track” sign; “3-line” or “4-line” sign, or “bull's eye” appearances on transverse scan. 7 …”

Section: Discussionmentioning

confidence: 99%

Intestinal Obstruction in a 3-Year-Old Girl by Ascaris lumbricoides Infestation

et al. 2015

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Ascaris lumbricoides infection affects approximately 1.5 billion people globally. Children with environmental and socio-economic risk factors are more susceptible to infestation, with serious complications such as intestinal obstruction (IO), volvulus, intussusception, and intestinal necrosis.We present the case of a 3-year-old girl who arrived at emergency department with abdominal pain and diarrhea for the last 3 days. The previous day she took an unspecified anthelmintic. Symptoms worsened with vomiting and diarrhea, with expulsion of roundworms through mouth and anus. Physical examination revealed bloating, absence of bowel sounds, abdominal tenderness, and a palpable mass in right hemi-abdomen. Abdominal radiographs showed air-fluid levels with mild bowel distention and shadows of roundworms. The diagnosis of IO by A lumbricoides. infestation was established and surgical approach scheduled. During exploratory laparotomy an intraluminal bolus of roundworms from jejunum to ascendant colon was evident. An ileum enterotomy was performed and worms were removed. Fluid therapy and antibiotics for 72 hours were administered, with posterior albendazol treatment for 3 days. Patient was uneventfully discharged on the tenth day.Reduction in parasitic load by means of improvements in sanitation, health education, and anthelmintic treatment must be implemented in endemic zones to prevent serious life-threatening complications by A lumbricoides. infestation, because some of them require urgent surgical treatment.

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“…The most commonly known serious and lethal complication of A. lumbricoides infection is intestinal obstruction, caused by an aggregated mass of A. lumbricoides worms, which may develop acutely or subacutely [9]. Early diagnosis of intestinal obstruction caused by A. lumbricoides using ultrasonography is very useful to avoid its serious and lethal complications [10]. Emergency surgical treatment may be necessary in acute intestinal obstruction in which the mass of the parasite obstructs the intestinal lumen or intestinal obstruction develops due to volvulus [11].…”

Section: Introductionmentioning

confidence: 99%