A Case Report of Roundworms Causing Intestinal Obstruction in a Child

• Published in: Case reports in surgery 2024-04, Vol.2024, p.6640941-5
• Main Authors: Krishnaraju, Tushar, Jena, Suvendu Sekhar, Yadav, Amitabh, Nundy, Samiran
• Format: Article
• Language: English
• Subjects: Abdomen; Albendazole; Antibiotics; Ascaris lumbricoides; Asymptomatic; Case Report; Case reports; Ceftriaxone; Children; Computed tomography; Disease transmission; Drinking water; Emergency medical care; Emergency medical services; Gangrene; Global health; Health aspects; Health promotion; Histopathology; Hygiene; Ileostomy; Ileum; Infections; Intestinal obstruction; Intestine; Intestines; Jejunum; Metronidazole; Nematodes; Obstructions; Ostomy; Pain; Peritonitis; Public health; Sanitation; Small intestine; Socioeconomic factors; Surgical anastomosis; Toxins; Tropical diseases; Tuberculosis; Vomiting; Worms
• ISSN: 2090-6900; 2090-6919
• DOI: 10.1155/2024/6640941

Background. Soil-transmitted helminth (STH) infections are a common global health issue that affects underprivileged communities without adequate access to clean drinking water, sanitation, and hygiene. Ascaris lumbricoides is the main species that infects humans. Among varied presentations, intestinal obstruction is common among children. Early detection of intestinal obstruction due to STH is critical to prevent severe complications. Here, we present the case of a 10-year-old child with acute intestinal obstruction due to roundworms. Case Report. A 10-year-old boy presented to the emergency department with recurrent abdominal pain, distention, and vomiting for three months with signs of peritonitis on examination. CT scan of the abdomen revealed roundworms in the distal ileum and a cocoon formed by adhesions of small bowel loops. Intraoperatively, worm balls were found in the proximal jejunum and ileum, causing small bowel obstruction, and a diseased segment of ileum had to be resected. The worms were removed, and an ileostomy was created. The patient was treated with albendazole and intravenous antibiotics such as ceftriaxone and metronidazole. An early closure of ileostomy was performed after 20 days. Histopathology showed roundworm eggs in the appendix and small bowel mucosa. Discussion. Ascaris lumbricoides infestation is a common cause of intestinal obstruction in children, and early detection is critical for avoiding severe complications. Prompt and appropriate treatment with antihelminthics and antibiotics is necessary to achieve a good outcome. In rare cases, surgical intervention may be required to treat intestinal obstruction caused by STH infections. In conclusion, the prevalence of STH infections highlights the need for public health interventions, such as improving access to clean water, sanitation, and hygiene, and for early detection and treatment to prevent severe complications such as intestinal obstruction.