|Year : 2020 | Volume
| Issue : 2 | Page : 128
Ascariasis and Intestinal Obstruction: Pre-operative hints!
Sruthi Shasheendran, Enono Yhoshu, Gyanendra Chaudhary, Manish Kumar Gupta
Department of Pediatric Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
|Date of Submission||27-May-2020|
|Date of Decision||27-May-2020|
|Date of Acceptance||16-Jun-2020|
|Date of Web Publication||15-Dec-2020|
Dr. Enono Yhoshu
6th Floor A Block, Department of Pediatric Surgery, All India Institute of Medical Sciences, Veerbhadra Road, Rishikesh - 249 203, Uttarakhand
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Shasheendran S, Yhoshu E, Chaudhary G, Gupta MK. Ascariasis and Intestinal Obstruction: Pre-operative hints!. J Med Evid 2020;1:128
A 4-year-old boy with acute intestinal obstruction, worms in vomitus and history of pica presented in a sick condition – toxic, pale and dehydrated. The total leucocyte count was 2000 cells/mm3 (n = 5000–15,500) and haemoglobin = 8.8 g/dl (n = 11.5–13.5). X-ray abdomen (AXR) showed dilated bowel loops with multiple air-fluid levels (>5) and some curvilinear opacities in the bowel lumen [Figure 1]. He was resuscitated, and on exploratory laparotomy, a gangrenous segment of distal ileum loaded with roundworms was found. Gangrenous segment was resected and ileostomy was created. Postoperatively, he was managed aggressively, but he expired on post-operative day 3 due to septic shock.
|Figure 1: X-ray abdomen showing curvilinear opacities suggestive of worms (white arrow)|
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Intestinal obstruction due to Ascaris can be suggested by several clues in history, i.e., worm in vomitus or stool and AXR, wherein the individual worm may be seen as opacity against the bowel gas lying longitudinally or transversely, and clumps of worms may be seen as opacities as in our case, or as 'cigar bundles' or 'whirlpool appearance'.
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