Obstrucción intestinal por Ascaris lumbricoides en un adulto mayor / Intestinal obstruction due to Ascaris lumbricoides infection in a geriatric patient

Ascaris lumbricoides is considered the largest intestinal nematode with a higher incidence in the childhood, representing a truly medical and public health problem, principally in undeveloped countries. We present the case of an 83 year old man, born and coming from the amazon region, without any relevant previous history of disease, admitted in the emergency department of our hospital for presenting intestinal obstruction and also presumptive biliary obstruction due to multiple balls of parasites, requiring immediate surgical intervention. We emphasize the need of consider this etiologic possibility in the differential diagnosis, that in this particular case, wasn't suspected in the first place.

Ascaris lumbricoides es considerado el nemátodo intestinal de mayor tamaño. Se presenta con mayor frecuencia en la infancia, representando un verdadero problema médico y de salud pública, especialmente en países en vías de desarrollo. Presentamos el caso de un varón de 83 años, natural y procedente de la región amazónica del Perú, sin antecedentes médicos de relevancia, que ingresa a Servicio de urgencias de nuestro hospital por un cuadro de obstrucción intestinal y presunta obstrucción biliar, requiriendo una intervención quirúrgica inmediata. El diagnóstico final de obstrucción intestinal por la presencia de múltiples ovillos de Ascaris lumbricoides, no fue considerado dentro de los diagnósticos diferenciales previo al acto quirúrgico.

Intestinal obstruction due to ascaris lumbricoides infestation in adult presenting as lump in right lliac fossa

Ascaris lumbricoides [AL] is a common resident of intestine especially in low socioeconomic areas of the world. Ascariasis can cause serious intra-abdominal complications such as intestinal obstruction, biliary obstruction, pancreatitis, acute appendicitis, intestinal perforation etc. We report an adult with intestinal obstruction due to entangled mass of AL, that presented as a lump in right iliac fossa, managed by laparotomy and milking the worms into colon without enterotomy

Report of a case with small bowel obstruction by a rare parasite [Pentastomiasis]

Linguatula serrata [L. serrata], an aberrant arthropod of the Pentastomida phylum, inhabits the canine respiratory system as its final host. Intermediate hosts include humans and herbivores. Humans can be infected via consumption of raw or under-cooked liver or lymph nodes of sheep, goats, and cattle. A few human cases have been reported from Iran. Here, we have reported a case of pentastomiasis infection in a 55-year-old man who presented with fever, abdominal pain, abdominal distension, and weight loss. Small bowel transit revealed partial obstruction in the small intestine. Abdominal CT scan showed increased small bowel wall thickness. Both laparoscopy and biopsy findings favored parasitic granuloma from a pentastomiasis infection. He was administered praziquantel and albendazole. After two weeks of therapy the patient recovered

Unusual presentations of malaria in children: an experience from a tertiary care centre in north east India.

Objective. To identify cases of malaria with unusual presentations. Methods. The medical record of all the cases of malaria admitted to PICU and pediatric general ward from Oct 2006 to Sep 2009, were reviewed and cases with unusual presentations were identified. The study design was retrospective descriptive study. Results. Sixteen (10%) out of 162 malaria cases had unusual presentations - three had hemiplegia, two each with viral hepatitis-like presentation, acute abdomen, gastrointestinal bleed, generalized edema and hyperglycemia and one each with ptosis, severe headache and subacute intestinal obstruction-like presentation. Eleven cases had mixed parasitemia and two each with P. vivax and P. falciparum. One case was diagnosed on clinical grounds. Conclusions. Malaria is a common disease, but both typical and atypical presentations deserve attention for early diagnosis and management.

CT Findings of Surgically Verified Acute Invasive Small Bowel Anisakiasis Resulting in Small Bowel Obstruction

Acute invasive small bowel anisakiasis is an extremely rare cause of small bowel obstruction. The authors report a case of surgically verified small bowel anisakiasis resulting in small bowel obstruction. A 54-year-old man presented with suddenly developed diffuse abdominal pain after ingestion of raw fish. The peripheral blood examination showed leukocytosis without eosinophilia. CT showed a long segment of thickened small bowel accompanied by a focal narrowed portion and combined with ascites. When these findings are noted in patients with a history of recent ingestion of raw or undercooked fish, the diagnosis of small bowel anisakiasis should be considered in order to avoid application of unnecessary surgical treatment, in spite of the severity of the abdominal pain and bowel obstruction.

Large intestine obstruction complicated with perforation: a rare manifestation of Schistosoma mansoni infection

The authors report a case of a 25 year old Brazilian man with a history of crampy abdominal pain in the left iliac fossa for 2 weeks, abdominal distention, mucous diarrhea and anorexia. The patient presented signs of hemodynamic instability and a hard mass palpated in the left iliac fossa presented peritoneal irritation. At laparotomy, fecal peritonitis and a punched-out perforation of the midsigmoid colon were found. A left hemicolectomy was performed with terminal colostomy. Specimen examination revealed a thickened rectosigmoid wall, narrow lumen and multiple mucosal polyps. Microscopically, chronic granulomatous colitis with Schistosoma mansoni eggs confirmed the etiology. To the authors'knowledge, this is the first case of obstruction complicated with perforation due to mansoni schistosomiasis reported in the literature.

Obstruçäo intestinal por "ascaris lumbricoides" / Intestinal obstruction by ascaris lumbricoides

Os autores apresentam estudo retrospectivo de 17 pacientes submetidos a tratamento cirúrgico por obstruçao intestinal provocada por Ascaris Lumbricoides. Clinicamente os pacientes apresentavam dor e distensao abdominal, vômitos e parada de eliminaçao de gases e fezes. Os procedimentos cirúrgicos realizados foram enterotomia com retirada dos vermes, mobilizaçao distal por ordenha e ressecçao com anastomose intestinal. Ocorreram dois óbitos (11,8 por cento). Os autores discutem a necessidade de avaliaçao cuidadosa destes pacientes.

Urgências abdominais näo traumáticas na criança / Non-traumatic abdominal emergencies in children

As urgências abdominais näo traumáticas da criança apresentam características próprias, relacionadas às diferentes faixas etárias. Discutem-se, neste artigo, a orientaçäo diagnóstica e os cuidados pré-, intra- e pós-operatórios de algumas dessas urgências, tais como apendicite aguda, hérnia inguinal encarcerada, estenose hipertrófica de piloro, intussuscepçäo intestinal, divertículo de Meckel e obstruçäo por bolo de áscaris

Ascariasis: a surgical problem in children

Complications of ascariasis requiring surgical intervention have been frequently recorded in the literature, intestinal obstruction is the commonest complication, and could be produced by several mechanisms. In the majority of our cases, the obstruction was subacute and responded to conservative treatment. If the response is unsatisfactory, dispersal of the worms without opening the bowel should be tried firstly. But, there should be no hesitation to resect bowel if necessary. Perforation of the bowel is the most serious complication. It can occur in ulcerative lesions of the small intestine especially due to typhoid fever, meckel's and caecal diverticulitis with perforation and escape of ascaris into the pritoneal cavity have also been described [Van Rensburg and Kark, 1958]. It should be serious to perform intestinal resection in the presence of ascaris. For this reason, elective operation on the gastro-intestinal tract should be delayed until eradication of ascaris. We discussed our results in 28 children who presented with complications due to ascariasis