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Intestinal obstruction due to ascariasis

P P Wasadikar1, A B Kulkarni

  • 1Swami Ramanand Teerth Rural Medical College, District Beed Maharashtra, India.

The British Journal of Surgery
|March 1, 1997
PubMed
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Intestinal obstruction caused by Ascaris lumbricoides (roundworm) is a serious condition. Early diagnosis with imaging and timely surgery can significantly lower the mortality rate in these cases.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Ascariasis, a heavy roundworm infestation, can lead to intestinal obstruction.
  • This study reviews 92 patients experiencing intestinal obstruction due to Ascaris lumbricoides.

Purpose of the Study:

  • To analyze the outcomes of patients with intestinal obstruction caused by Ascaris lumbricoides.
  • To evaluate the effectiveness of conservative and surgical management strategies.
  • To highlight the role of diagnostic imaging in improving patient outcomes.

Main Methods:

  • Patients were categorized into two groups: those without peritonism (treated conservatively) and those with signs of strangulation (requiring surgical intervention).
  • Conservative treatment included resuscitation, antibiotics, and anthelminthics.

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  • Diagnostic tools included plain abdominal radiography and, in a subset of patients, abdominal ultrasonography.

    • Main Results:

    • The conservative group (68 patients) had no mortality and a short hospital stay (4-7 days).
    • The surgical group (24 patients) had a higher mortality rate (50%), with 12 deaths during resuscitation or post-operation.
    • Ultrasonography identified characteristic signs of ascariasis ('railway track', 'bull's eye') and strangulation, aiding diagnosis.

    Conclusions:

    • Early clinical diagnosis, supported by ultrasonography, is crucial for managing Ascaris-induced intestinal obstruction.
    • Prompt surgical intervention when indicated can potentially reduce the mortality associated with this condition.