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Surgical management of worm volvulus
1Department of General Surgery, University of Natal, Durban.
Summary
Small-bowel volvulus complicating ascariasis is a serious condition. Early detection and surgery are crucial to reduce high mortality and morbidity rates associated with this parasitic worm infestation.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Pathology
Background:
- Intestinal ascariasis, caused by the roundworm Ascaris lumbricoides, can lead to serious gastrointestinal complications.
- Small-bowel volvulus, a twisting of the intestine, is a rare but life-threatening complication of ascariasis.
Purpose of the Study:
- To analyze the clinical presentation, management, and outcomes of patients with small-bowel volvulus secondary to intestinal ascariasis.
- To highlight the significance of early diagnosis and surgical intervention in improving patient survival.
Main Methods:
- A retrospective analysis of 50 consecutive patients diagnosed with small-bowel volvulus complicating intestinal ascariasis.
- Review of patient demographics, clinical symptoms, radiographic findings, surgical procedures, and mortality data.
Main Results:
- Abdominal distension and pain were the most frequent presenting symptoms.
- 39 patients required bowel resection due to gangrene, and the overall mortality rate was 14.5%.
- All deaths occurred in patients with gangrenous bowel requiring resection.
Conclusions:
- Small-bowel volvulus complicating ascariasis remains a condition with significant mortality and morbidity.
- Prompt surgical intervention is essential for managing this potentially fatal complication of ascariasis.