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Updated: Aug 4, 2025
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Ascaris lumbricoides a rare cause ileal perforation, a case report
Yohannis Derbew Molla1, Andinet Desalegn Beza1, Amanuel Kassa Tadesse2
1Department of Surgery, University of Gondar, Collage of Medicine and Health Sciences, Gondar, Ethiopia.
Insights
Ascariasis, a parasitic worm infection, can cause severe abdominal issues in children, including rare cases of intestinal perforation. Prompt diagnosis and treatment are crucial for managing these serious complications.
Area of Science:
- Tropical Medicine
- Pediatric Surgery
- Infectious Diseases
Background:
- Ascariasis is a common helminthic infection caused by Ascaris lumbricoides.
- In pediatric patients, Ascaris infection can lead to various gastrointestinal complications.
Observation:
- A 2-year-old Ethiopian girl presented with vomiting, abdominal distension, and cramps.
- Clinical examination revealed signs of dehydration, necessitating resuscitation and surgical intervention.
Findings:
- While ascariasis is a rare cause of intestinal perforation, it can present with severe abdominal complications like obstruction, intussusception, and appendicitis.
- Ileum perforation in ascariasis can result from direct pressure, inflammation, or secondary necrosis.
Implications:
- Ascariasis should be considered in the differential diagnosis of peritonitis in children, particularly those from or who have traveled to endemic regions.
- Early recognition and surgical management are vital for favorable outcomes in complicated pediatric ascariasis.
Introduction And Importance:
Ascariasis is a helminthic infection of humans caused by Ascaris lumbricoides. Pediatric patients infected with Ascaris can develop multiple complications including appendicitis, gastrointestinal bleeding, hepatobiliary disease like cholangitis or obstructive jaundice, intussusception, and bowel obstruction among others. Ascaris is a rare cause of intestinal perforation even in endemic areas.
Case Presentation:
A 2-year-old female Ethiopian toddler who was presented with a complaint of non-bilious, non-projectile vomiting of 06 days duration, about two-three episodes per day. Associated with this she had had progressive abdominal distension, intermittent abdominal cramps and loss of appetite. On examination, she was acutely sick looking. She had signs of dehydration. Subsequently, she was resuscitated, broad spectrum antibiotic started and operated. Finally, the child was discharged improved after 7 days of hospital stay.
Clinical Discussion:
The clinical presentation of ascariasis can vary from asymptomatic child to one with severe disease requiring surgical intervention like our patient. Severity of disease depends on the worm burden; heavy worm infestation produces a wide range of acute abdominal complications such as intestinal obstruction, intussusception, cholangiohepatitis, pancreatitis, and acute appendicitis. Intestinal ascariasis rarely causes volvulus and intestinal gangrene, perforation and peritonitis.
Conclusion:
Ascariasis must be considered in the differential diagnosis in patients presented with peritonitis especially those living or from temperate and tropical countries with a history of passage of worms. Ileum perforation is possible in patients with ascariasis due to pressing directly into the bowel wall, inflammatory reaction, or volvulus and intestinal wall necrosis.
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