Concluded Case

round worm intestinal obstruction

Posting a case done long back for sharing the same with the budding surgeons A young female presented with features of small bowel obstruction with features of peritonism Exploratory laprotomy was done It was found that the whole of small bowel was packed with round worms Enterotomy was done and all the round worms evacuated Post op uneventful

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THANKS DR Ajit Jangbahadur for presenting this interestingcase It still remember 23 years back ,when I was registrar - we used to see bolus Obstruction due to Ascariasis .But now a days less number of cases are seen .Ascariasis is a common parasitic infection in underdeveloped  nations. It is caused by the roundworm Ascaris lumbricoides, which lives in the intestines of its infected hosts and transmits eggs through the feces of its hosts.2 The most common routes of entry for roundworms include oral ingestion from drinking water in which the parasite’s eggs are present, or subcutaneously through bare feet that come in contact with infected feces. Ascariasis is common in locations where there is poor hand hygiene, poor sanitization, and use of human feces as soil. The eggs of the parasite first hatch in the intestines of its infected host and the larvae move into the bloodstream, where it establishes residency in the lungs.3 After a process of maturing, the roundworms leave the lungs and travel into the trachea, where they are expectorated or swallowed into the esophagus. The worms that are ingested travel back into the intestines, where they continue to grow, mate, and produce additional eggs. The cycle continues as eggs are either excreted through the feces or hatch in the intestines and travel to the lungs via the bloodstream. An uninterrupted progression of the parasitic infection can lead to small bowel obstruction as the roundworms reproduce in the intestines to a level that impedes the normal flow of digestive material through the GI tract. As the digestive tract becomes obstructed, the patient will begin to experience generalized abdominal pain, nausea, vomiting, and poor appetite. If left untreated, the condition can lead to death as the patient becomes dehydrated or the bowels are perforated by a worsening obstruction.

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THANKS DR Ajit Jangbahadur for presenting this interestingcase It still remember 23 years back ,when I was registrar - we used to see bolus Obstruction due to Ascariasis .But now a days less number of cases are seen .Ascariasis is a common parasitic infection in underdeveloped  nations. It is caused by the roundworm Ascaris lumbricoides, which lives in the intestines of its infected hosts and transmits eggs through the feces of its hosts.2 The most common routes of entry for roundworms include oral ingestion from drinking water in which the parasite’s eggs are present, or subcutaneously through bare feet that come in contact with infected feces. Ascariasis is common in locations where there is poor hand hygiene, poor sanitization, and use of human feces as soil. The eggs of the parasite first hatch in the intestines of its infected host and the larvae move into the bloodstream, where it establishes residency in the lungs.3 After a process of maturing, the roundworms leave the lungs and travel into the trachea, where they are expectorated or swallowed into the esophagus. The worms that are ingested travel back into the intestines, where they continue to grow, mate, and produce additional eggs. The cycle continues as eggs are either excreted through the feces or hatch in the intestines and travel to the lungs via the bloodstream. An uninterrupted progression of the parasitic infection can lead to small bowel obstruction as the roundworms reproduce in the intestines to a level that impedes the normal flow of digestive material through the GI tract. As the digestive tract becomes obstructed, the patient will begin to experience generalized abdominal pain, nausea, vomiting, and poor appetite. If left untreated, the condition can lead to death as the patient becomes dehydrated or the bowels are perforated by a worsening obstruction.

Thank you doctor
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