Retroperitoneal ascariasis: A case report

ABSTRACT

@#Infection with adult Ascaris primarily occurs in the gastrointestinal system, but physical migrationother than this has been reported. To date, only a small number of cases have been reported to involvethe urinary system and no report of Ascariasis migration to the retroperitoneal space.This is a case of a 38-year-old female admitted as a case of perinephric abscess, renal mass right.Patient was initially managed conservatively with broad spectrum antibiotics and tube drainage, butwith the deteriorating condition, an exploratory laparotomy, with retroperitoneal exploration wasdone. During exploration, no colonic fistula was noted. The renal parenchyma was noted to bepinkish with a 1cm opening at the mid lateral pole associated with purulent discharge. Interestingly,a 6cm x 1cm wax-like, moving structure was found in the retroperitoneal space The object wasremoved with Debakey forceps and was determined to be Ascaris lumbricoides by histopathology.Fecal analysis of stool for ova and parasites was negative for Ascaris. The patient then had an uneventfulrecovery.Currently, there are only two theories on how Ascaris lumbricoides can be introduced into the urinarysystem. The first includes fistulation between the GI and urinary system and second by retrogrademigration of the adult worm through the urethra. Given the current data, the authors believe that thepatient experienced retrograde invasion of Ascaris through the urethra, and subsequently migrated tothe retroperitoneal space through fistulation.Ascariasis of the genitourinary tract is a rare condition. This is the first reported case of ascariasis inthe retroperitoneum.