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Intestinal Obstruction in a Child with Massive Ascariasis

Munanura Turyasiima1,2, Paul Matovu3, Gloria Kiconco1,2

  • 1Pediatrics and Child Health Department, Kisiizi Hospital Church of Uganda, Kabale, Uganda.

Case Reports in Pediatrics
|January 28, 2021
PubMed

Insights

Massive ascariasis, a common roundworm infection, rarely causes intestinal obstruction in children. This case highlights a rare pediatric presentation of Ascaris lumbricoides leading to surgical intervention.

Area of Science:

  • Tropical medicine
  • Pediatric surgery
  • Infectious diseases

Background:

  • Soil-transmitted helminths, particularly Ascaris lumbricoides, are highly prevalent in tropical and developing regions.
  • Ascariasis is the most common helminth infection globally, yet intestinal obstruction is an uncommon pediatric complication.

Observation:

  • A 4-year-old girl presented with acute abdominal pain, vomiting, and passing roundworms nasally.
  • Physical examination revealed a palpable abdominal mass and mild constipation.
  • Nasal passage of worms is a rare but notable symptom of severe ascariasis.

Findings:

  • Exploratory laparotomy confirmed massive ascariasis with a significant worm burden.
  • A large number of Ascaris lumbricoides were removed via enterotomy.
  • The child underwent successful surgical management and postoperative albendazole treatment.

Implications:

  • This case underscores the importance of considering ascariasis in pediatric patients with abdominal symptoms, even with unusual presentations.
  • Early diagnosis and surgical intervention are crucial for managing intestinal obstruction caused by Ascaris lumbricoides.
  • Effective deworming strategies are essential for preventing severe complications of soil-transmitted helminth infections in endemic areas.

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