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Role of ascariasis in surgical abdominal emergencies in the Rangoon Children's Hospital, Burma
Thein-Hlaing1, Myat-Lay-Kyin, Hlaing-Mya
1Epidemiology Research Division, Department of Medical Research, Rangoon, Burma.
Insights
Ascariasis significantly complicates acute abdominal emergencies in children, leading to more surgeries, longer hospital stays, and higher mortality. Controlling ascariasis offers substantial socio-economic benefits.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Public Health
Background:
- Ascariasis is a common helminthic infection globally.
- Complications of ascariasis can lead to acute surgical abdominal conditions in children.
- The impact of ascariasis on pediatric surgical admissions requires detailed investigation.
Purpose of the Study:
- To evaluate the role of ascariasis in acute abdominal surgical conditions in children.
- To compare morbidity, duration of operation, hospital stay, and mortality in ascariasis-induced versus non-ascariasis-induced surgical cases.
- To highlight the socio-economic implications of ascariasis control.
Main Methods:
- Retrospective study of pediatric patients (1 month to 12 years) admitted with acute abdominal surgical conditions.
- Analysis of operation theatre registers and in-patient clinical sheets for 226 cases with ascariasis and 206 cases without.
- Comparison of outcomes including morbidity, operative time, hospital stay, and mortality.
Main Results:
- Ascariasis accounted for 7.5% of laparotomies, 10.6% of emergency abdominal admissions, and 26.3% of emergency operations.
- All operated biliary obstruction cases were due to ascariasis.
- Ascaris-induced conditions showed higher mean ages at operation, longer operative durations, extended hospital stays, and increased case fatality rates compared to non-Ascaris-induced cases.
Conclusions:
- Ascariasis is a significant cause of acute abdominal surgical emergencies in children, associated with poorer outcomes.
- Surgical interventions for ascariasis-related complications are frequent and carry higher risks.
- Effective control of ascariasis can yield considerable socio-economic benefits by reducing the burden of pediatric surgical emergencies.
Abstract:
Patients aged 1 month to 12 years admitted with an acute abdominal surgical condition comprising 226 cases with and 206 cases without ascariasis, recorded in the operation theatre registers and in-patients clinical sheets, were studied in relation to morbidity, duration of operation and hospital stay and mortality. Annually, 7.5% of laparotomies were due to complications of ascariasis. Operations for ascariasis accounted for 10.6% of all hospital admissions for an acute abdominal emergency. Also, ascariasis accounted for 26.3% of emergency operations. All operated biliary obstruction cases were due to ascariasis. Moreover, 20.4% of all cases of ascariasis with abdominal complications required operation. The mean ages at operation were higher in Ascaris-induced than in non-Ascaris-induced intestinal obstruction (5.1 vs 3 yr), intussusception (3.5 vs 1.2 yr) and volvulus (4.8 vs 1.7 yr). The durations of operation and hospital stay were longer and case fatality rates higher in Ascaris-induced than in non-Ascaris-induced cases. The importance of this study in relation to the socio-economic benefits of controlling ascariasis is discussed.