Mechanical intestinal obstruction due to Ascaris lumbricoides

Abstract

It is considered that approximately a quarter of the world population is infected with Ascaris lumbricoides and many people die annually as a consequence of it. Ascariasis presents a higher prevalence in children of tropical and subtropical countries, especially in the regions where poverty, overcrowding and bad environmental sanity are typical. Most of the patient’s progress well with the pharmacological treatment. However, on occasions emergency surgical treatment is needed. This study presents the clinical case of a 19-year-old white female patient who presented to the office with diffuse abdominal pain, mostly in the epigastric, periumbilical region in the lower abdomen, with a colic-like pain of variable intensity and abdominal distension, feeling that something was changing inside, accompanied by vomiting containing food and then clear bile, with cramps. The patient stated that she had spent more than 15 days without defecating and with no expulsion of intestinal gasses. The physical examination, the clinical manifestations and the radiological tests (ultrasound) confirmed the diagnosis of intestinal obstruction due to Ascaris lumbricoides, a rare condition in Cuba. Surgical intervention was performed with an exploratory laparotomy what showed a massive parasitemia within the intestinal loops. By means of loop squeezing techniques the exit of many adult parasites was corroborated. The patient progressed favorably.