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Clinical appraisal of Ascaris lumbricoides, with special reference to surgical complications
B Mukhopadhyay1, S Saha, S Maiti
1Department of Pediatric Surgery, Institute of Postgraduate Medical Education and Research & SSKM Hospital, Calcutta, India.
Insights
Pediatric abdominal colic caused by roundworms can often be treated conservatively. Early recognition of roundworm-induced intestinal issues prevents serious surgical complications and reduces patient morbidity.
Area of Science:
- Pediatric Gastroenterology
- Hepatobiliary Surgery
Background:
- Abdominal colic in children can be associated with intestinal obstruction.
- Passage of adult roundworms in stool or vomitus indicates a potential cause.
Purpose of the Study:
- To evaluate the treatment outcomes for pediatric abdominal colic due to roundworms.
- To compare conservative versus surgical management strategies.
Main Methods:
- Retrospective analysis of 509 pediatric patients (6 months to 10 years) treated for roundworm-related abdominal colic from 1993-1997.
- Patients received initial conservative management with antispasmodics and saline enemas, followed by anthelminthics.
- Surgical intervention was performed when conservative measures failed or for associated pathologies.
Main Results:
- Conservative management was successful for 105 out of 209 hospitalized patients.
- 50% of hospitalized patients (104) required surgical intervention, including worm extraction and resection/anastomosis.
- Five postoperative deaths occurred, all in the surgical group; no deaths occurred in the conservatively managed group.
Conclusions:
- Conservative management of roundworm-induced abdominal colic in children is effective and associated with lower morbidity.
- Early diagnosis and prompt treatment are crucial to avoid surgical complications and mortality.
Abstract:
Over a period of 4 years (January 1993-December 1997), 509 patients were treated for abdominal colic with or without intestinal obstruction and a history of passage of adult roundworms either in the stool or in vomitus. All patients were below the age of 10 years, the youngest 6 months old, and were treated successfully with antispasmodics and normal saline enemas. When the pain subsided, an anthelminthic drug was given. Of 209 patients admitted to the hospital, 105 responded to conservative management and 104 (50%) required surgical intervention. The procedures included squeezing out of worms, resection and anastomosis, and treatment of other pathologies like acute appendicitis, tubercular stricture of the small intenstine, etc. Five patients died in the postoperative period due to various complications. There were no deaths among those treated by conservative management. Early recognition of the condition can prevent serious surgical complications and morbidity.
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