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Duodenal perforation with an unusual presentation: a case report
Arif Hussain Sarmast1, Fazl Q Parray, Hakim Irfan Showkat
1Department of Surgery, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar 190011, Jammu and Kashmir, India.
Case Reports in Infectious Diseases
|May 9, 2012
Summary
Ascaris lumbricoides caused a duodenal perforation in a young female patient presenting with peptic ulcer disease symptoms. This rare parasitic complication led to peritonitis and required emergency surgery.
Area of Science:
- Gastroenterology
- Parasitology
- Surgical Pathology
Background:
- Peptic ulcer disease (PUD) commonly presents with upper abdominal pain and can lead to serious complications.
- Peritonitis, inflammation of the peritoneum, is a surgical emergency often resulting from gastrointestinal perforation.
- Ascariasis, caused by the roundworm Ascaris lumbricoides, is a common intestinal parasite, but gastrointestinal perforation is a rare complication.
Observation:
- A young female patient exhibited symptoms consistent with PUD, progressing to signs of peritonitis.
- Diagnostic workup preceded an exploratory laparotomy due to the severity of her condition.
- Intraoperative findings revealed a live Ascaris lumbricoides worm emerging from a perforation in the duodenum.
Findings:
- The duodenal perforation was directly attributed to the presence of a live Ascaris lumbricoides.
- This case highlights an unusual parasitic cause of a surgical emergency typically associated with peptic ulcer disease.
- Microscopic examination confirmed the presence of the nematode within the perforated duodenal tissue.
Implications:
- This case underscores the importance of considering parasitic infections in the differential diagnosis of gastrointestinal emergencies, even in regions where PUD is more prevalent.
- It highlights a rare but severe complication of ascariasis, emphasizing the need for prompt diagnosis and treatment of parasitic infestations.
- Clinicians should be aware of the potential for Ascaris lumbricoides to cause duodenal perforation, necessitating surgical intervention.
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