Related Experiment Videos
Primary ascaridial perforations of small intestine and Meckel's diverticulum
V K Hangloo1, I Koul, R Safaya
1Department of Surgery, Medical College, Srinagar.
Abstract:
The clinical presentation of six cases with primary ascaridial perforations of the terminal ileum (4 cases) and Meckel's diverticulum (2 cases), without any associated underlying intestinal disease, is described. All the cases presented clinically as peritonitis and had worm masses in the intestinal lumen with maximal impaction in the terminal ileum. Ileal perforations were surgically closed in two layers after removal of the worms. Diverticulectomy after removal of the worms was performed for Meckelian diverticular perforations. Peritoneal toilet was done in all the cases. Pressure necrosis from the impacted worm masses probably resulted in these perforations.
Insights
Primary Ascaris infections can cause intestinal perforations, particularly in the ileum and Meckel
Area of Science:
- Gastroenterology
- Surgical Pathology
- Parasitology
Background:
- Intestinal perforations are serious complications.
- Ascaris lumbricoides infections can lead to intestinal obstruction and perforation.
Purpose of the Study:
- To describe the clinical presentation and management of primary intestinal perforations caused by Ascaris.
- To investigate the role of Ascaris impaction in ileal and Meckel's diverticulum perforations.
Main Methods:
- Retrospective case series of six patients with Ascaris-induced perforations.
- Clinical presentation, surgical findings, and treatment outcomes were analyzed.
- Surgical intervention included worm removal, perforation closure, or diverticulectomy, and peritoneal lavage.
Main Results:
- Four cases involved terminal ileum perforations, and two involved Meckel's diverticulum.
- All patients presented with peritonitis due to worm masses causing impaction and pressure necrosis.
- Surgical repair and worm removal were successfully performed in all cases.
Conclusions:
- Primary Ascaris perforation of the ileum and Meckel's diverticulum is a distinct clinical entity.
- Prompt surgical intervention is crucial for managing Ascaris-induced intestinal perforations.
- Impacted Ascaris masses are the likely cause of perforation through pressure necrosis.