Wandering ascaris coming out through the abdominal wall

Area of Science:

• Gastroenterology
• Parasitology
• Surgical Case Reports

Background:

• Ascariasis, caused by Ascaris lumbricoides, is a common human parasitic infection.
• Complications can range from mild gastrointestinal upset to severe conditions like intestinal obstruction, peritonitis, and pancreatitis.
• Rarely, Ascaris lumbricoides can manifest through unusual external orifices.

Observation:

• A 40-year-old female presented with peritonitis following a dilatation and curettage procedure.
• Laparotomy revealed multiple ileal perforations, necessitating ileum resection and anastomosis.
• A fistula formed in the anterior abdominal wall, which later expelled a 10-cm Ascaris lumbricoides worm.

Findings:

• The primary finding is the extremely rare occurrence of an Ascaris lumbricoides worm exiting through an anterior abdominal wall fistula.
• This case underscores the diverse and severe clinical manifestations of ascariasis.
• The worm's emergence occurred 12 days postoperatively, indicating a delayed complication.

Implications:

• This case highlights the importance of considering parasitic infections in differential diagnoses, even with unusual presentations.
• It emphasizes the potential for Ascaris lumbricoides to cause significant morbidity and necessitate surgical intervention.
• Further awareness among healthcare providers about rare parasitic presentations is crucial for timely diagnosis and management.