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Large-bowel obstruction secondary to Enterobius vermicularis pseudotumour

Stephen O'Brien1, Sami Ahmed2, Brian Hayes3

  • 1Department of Surgery, Mercy University Hospital, Cork, Ireland stephenobrien@rcsi.ie.

BMJ Case Reports
|November 29, 2022
PubMed

Insights

A rare case of large-bowel obstruction in an elderly man was caused by pinworm (Enterobius vermicularis) infection, presenting as a pseudotumor. This highlights a critical, uncommon differential diagnosis for intestinal blockages.

Area of Science:

  • Gastroenterology
  • Parasitology
  • Surgical Pathology

Background:

  • Enterobius vermicularis (pinworm) infection commonly affects children, typically causing perianal pruritus.
  • Ectopic presentations and unusual manifestations of pinworm infection are infrequently reported in medical literature.

Observation:

  • A male patient in his 60s presented with symptoms of large-bowel obstruction, including abdominal pain, distension, vomiting, and constipation.
  • Imaging revealed an obstructing mass in the distal descending colon, leading to an emergency laparoscopic Hartmann's procedure.

Findings:

  • Intraoperative colonoscopy identified numerous threadworms within the colon.
  • Histological examination confirmed a pseudotumor associated with Enterobius vermicularis infection as the cause of obstruction.

Implications:

  • This case underscores the importance of considering Enterobius vermicularis infection as a rare differential diagnosis for large-bowel obstruction in adults.
  • It expands the known spectrum of clinical presentations for pinworm infections beyond typical pediatric cases.

Keywords:
Gastrointestinal surgeryGeneral surgeryHepatitis and other GI infectionsInfection (gastroenterology)

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