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Live ascaris in urinary bladder: a case report.

Gashaw Mesele¹, Zelalem Mengistu²

¹Department of Surgery, University of Gondar, Gondar, Ethiopia.

Journal of Medical Case Reports

|September 30, 2021

Summary

Ascaris infection in the urinary bladder is rare, often caused by a fistula. This case highlights the importance of considering ascariasis in urinary symptoms, especially in endemic areas.

Keywords:

Ascaris lumbricoides Urinary ascariasis Urinary helminthiasis Urinary parasites

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Area of Science:

Urology
Parasitology
Gastroenterology

Background:

Ascariasis (Ascaris lumbricoides infection) in the urinary bladder is an exceptionally uncommon occurrence.
Potential causes include enterovesical fistula formation or retrograde migration of adult worms.
This condition is frequently associated with significant clinical complications.

Observation:

A 47-year-old Ethiopian woman presented with a year-long history of incomplete bladder evacuation.
Ultrasonography revealed bladder wall thickening with echo debris and adjacent thickened, fluid-filled bowel loops.
Cystoscopy confirmed the presence of a live Ascaris worm within the urinary bladder.

Findings:

Explorative laparotomy identified an iliovesical fistula, confirming the gastrointestinal-urinary tract connection.
Surgical intervention involved dividing the fistula and restoring intestinal continuity.
Histopathology of an inflammatory mass showed a benign inflammatory reaction; the patient received antihelminthic treatment.

Implications:

This case underscores the necessity of maintaining a high index of suspicion for ascariasis in patients presenting with urinary symptoms, despite its rarity.
Prompt diagnosis and management, including surgical and antihelminthic treatment, can lead to favorable patient outcomes.
Highlights the complex interplay between parasitic infections and urological/gastrointestinal pathology.