Surgical complications of ascariasis
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1Department of Surgery, University of Antioquia, School of Medicine, Medellín, Colombia.
Insights
Intestinal parasitic infections, particularly ascariasis, cause severe abdominal complications in children. These conditions are endemic in areas with poor socioeconomic conditions and increasingly seen globally due to migration.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Public Health
Background:
- Intestinal parasitic infections are prevalent in children, especially in regions with socioeconomic disparities.
- Entamoeba histolytica and Ascaris lumbricoides infections can lead to severe abdominal complications.
- Global migration patterns are increasing the incidence of these infections in industrialized nations.
Purpose of the Study:
- To analyze the spectrum of abdominal complications in children caused by Entamoeba histolytica and Ascaris lumbricoides.
- To highlight the association between intestinal parasitism and socioeconomic conditions.
- To inform surgeons in industrialized nations about the rising incidence and management of these conditions.
Main Methods:
- Retrospective review of pediatric surgical admissions over 25 years (1963-1988).
- Analysis of cases with complications from Entamoeba histolytica and Ascaris lumbricoides.
- Evaluation of living conditions for a subgroup of patients.
Main Results:
- 145 cases of ascariasis-related abdominal complications were identified, including intestinal obstruction (107), appendiceal perforation (10), and biliary/peritoneal migration (28).
- Intestinal parasitism is linked to endemic conditions in nations with significant social and economic imbalance.
- Massive infestations in children can result in severe complications requiring surgical intervention.
Conclusions:
- Ascariasis and amebiasis pose significant surgical risks to children in underserved regions.
- Increased global mobility necessitates awareness and preparedness for these parasitic infections in developed countries.
- Effective management requires surgical expertise, particularly in hospitals serving low-income populations.
Abstract:
Over the past 25 years (1963-1988), a total of 311 children under 12 years of age were admitted to the Pediatric Surgical Service of the San Vicente de Paúl University Hospital, Medellín, Colombia, with complications resulting from infection with Entamoeba histolytica or Ascaris lumbricoides. In this group, the abdominal complications produced by ascariasis numbered 145, and included intestinal obstruction (n = 107), perforation of the appendix (n = 10), and migration of the parasite to the biliary tree or to the peritoneal cavity (n = 28). Evaluation of the living conditions of a significant subgroup of our patients confirms that intestinal parasitism is an endemic condition prevailing in nations that exhibit deep social and economic imbalance, where large sectors of the population remain deprived of the basic services of education, health, housing, and recreation. Massive infestation in children may give rise to grave complications that demand expert surgical care. Third World surgeons practicing in general hospitals that take care of patients of low economic capacity are usually familiar with the diagnosis and management of this pathology; surgeons who practice in the industrialized nations will only occasionally face such problems. The greater mobility of today's societies and the rather massive migrations that take place in current times have resulted in an increasing incidence of these entities in the hospital populations of the large urban centers of these nations. It is for the surgeons practicing in such centers that the information presented herein may be of greater value.