Non-operative management of intestinal obstruction due to ascaris lumbricoides

To compare, evaluate and analyze three different non-operative modalities of treatment of intestinal obstruction due to ascaris lumbricoides.

A non-randomized, cohort and comparative study.

Department of Pediatric Surgery, National Institute of Child Health, Karachi from March 2001 to October 2002.

A total of 45 patients with the diagnosis of intestinal obstruction due to ascaris lumbricoides were included in the study. They were divided in 3 groups of 15 patients each. Group I patients were given I/V fluids only, group II patients were given hyoscinbutylbromide in infusion and group III patients were given hypertonic saline enema. The outcome of all groups was compared in terms of improvement in obstruction and hospital stay. The data was analyzed by SPSS 11.0 by using ANOVA and HSD Tuckey test for multiple comparisons.

The non-operative treatment was successful in all of the patients. In group III improvement of intestinal obstruction occurred in 1.6 +/- 1.11 days (p value=0.001), whereas it was 2.6 +/-1.11 days in group II and 3.4 +/-1.35 days in group I. The mean hospital stay in group III was 4 +/-1.69 days (p value=0.003), whereas it was 6.27 +/- 2.31 days in group II and 5.87 +/-1.25 days in group I.

We recommend that hypertonic saline enema is a better non-operative treatment modality of intestinal obstruction, due to ascaris lumbricoides, in patients who do not have peritonitis. It is associated with early improvement of obstruction coupled with reduced hospital stay.