Figure 1 - uploaded by Amlan Gupta
Content may be subject to copyright.
Fig. 1a shows the gross appearance of the gangrenous small bowel loops adjacent to the viable bowel loops after laporotomy, about 25 cm in length upto approximately 15 cm proximal to the ileo ceacal junction. Fig. 1b shows milking of the proximal bowel being done following resection, which revealed both live and dead roundworms. Resection was done till the healthy bowel end denoted by bleeding from the cut bowel ends. Fig. 1c shows the whole resected gangrenous segment of small bowel along with the dead and alive roundworms milched from both the proximal and the distal ends of the bowel during laporotomy.
Source publication
Ascaris lumbricoides or round worm infestation is quite common in the developing world. It affects all age groups but is more common in children. Most of the cases remain asymptomatic. The usual presentation is an intestinal obstruction. The physicians should be aware of this condition and consider it in the differential diagnosis when faced with s...
Contexts in source publication
Context 1
... saline enemas which is used routinely in conservative manage- ment was also not used due to the risk of complications like perforation of small and large bowel, loss of fluids, dehydration and electrolyte disturbances. She underwent exploratory laparotomy under general anaesthesia the next morning, which revealed 1.5 litres of foul smelling hemorrhagic peritoneal fluid and about 25 cm of gangre- nous small intestine upto approximately 15 cm proximal to the ileo ceacal junction (Figure 1a). The proximal seg- ment of the bowel was filled with live roundworms forming a bolus, to such an extent that the outline of the worms could be made out through the stretched bowel wall. ...
Context 2
... gangrenous segment was resected after ligating the mesenteric ves- sels and every effort was made to prevent the further contamination of the peritoneal cavity. Following resec- tion, milking of the proximal bowel was done, which re- vealed both live and dead roundworms ( Figure 1b). After ensuring the viability of resected bowel ends, continuity of bowel was restored by a two layered end to end ana- stomosis. ...
Context 3
... thorough peritoneal lavage was given with warm normal saline. The whole of the resected bowel segment was sent for histopathological examination ( Figure 1c). The patient received one unit of compatible matched whole blood during surgery. ...
Context 4
... up by the host are once more swallowed back into the intestine to develop into adult worms. The size of an adult worm ranges from 15-40 cm in length and 3-5 mm in diameter [5], [6]. The clinical features due to the migrating larvae are pneumonia (Loeffler's syndrome), visceral damage, ur- ticarial rash, eosinophilia, abscess, hepatosplenomegaly Fig. 1a shows the gross appearance of the gangrenous small bowel loops adjacent to the viable bowel loops after laporotomy, about 25 cm in length upto approximately 15 cm proximal to the ileo ceacal junction. Fig. 1b shows milking of the proximal bowel being done following resection, which revealed both live and dead ...
Context 5
... to the migrating larvae are pneumonia (Loeffler's syndrome), visceral damage, ur- ticarial rash, eosinophilia, abscess, hepatosplenomegaly Fig. 1a shows the gross appearance of the gangrenous small bowel loops adjacent to the viable bowel loops after laporotomy, about 25 cm in length upto approximately 15 cm proximal to the ileo ceacal junction. Fig. 1b shows milking of the proximal bowel being done following resection, which revealed both live and dead ...
Context 6
... was done till the healthy bowel end denoted by bleeding from the cut bowel ends. Fig. 1c shows the whole resected gangrenous segment of small bowel along with the dead and alive roundworms milched from both the proximal and the distal ends of the bowel during laporotomy. Almost the whole nodal parenchyma is necrotic, strongly eosinophilic with ghosts of lymphocytes and of other tissue components. The reticulin network is ...
Similar publications
The soil-transmitted helminth (STH), Trichuris trichiura colonises the human large intestine where it may modify inflammatory responses, an effect possibly mediated through alterations in the intestinal microbiota. We hypothesised that patent T. trichiura infections would be associated with altered faecal microbiota and that anthelmintic treatment...
Hepatobiliary and pancreatic ascariasis (HPA) was described as a clinical entity from Kashmir, India in 1985. HPA is caused by invasion and migration of nematode, Ascaris lumbricoides , in to the biliary tract
and pancreatic duct. Patients present with biliary colic, cholangitis, cholecystitis, hepatic abscesses and acute pancreatitis. Ascarides tr...
To assess the effectiveness of a 20-week, broad intervention to prevent reinfection by Ascaris lumbricoides (AL) and Giardia lamblia (GL) among indigenous schoolchildren in northern Mexico.
A prospective, comparative, ecological study. Two isolated boarding schools, each hosting 100-120 children, 4-15 years of age, were selected based on physical i...
Citations
... It is relatively rare in developed countries. It is more common in low-income communities and in regions with poor sanitation [6] . The mechanisms of obstruction are occlusion of the intestinal lumen by worms packed in the distal ileum, as well as the localized volvulus of a segment of the terminal ileum due to the weight of the worms inside. ...
Unlabelled:
Ascaris lumbricoides is an infestation that affects approximately one-seventh of the world's population. Ascaris lumbricoides is a common inhabitant of the intestines of people with low-socioeconomic incomes, especially in underdeveloped countries of the world. Ascaris lumbricoides infestation is more prone to infestation with serious complications such as intestinal obstruction, volvulus, intussusception, and intestinal necrosis at higher rates in children than in adults.
Case presentation:
The authors present here two cases of small bowel obstruction caused by massive Ascaris lumbricoides that were admitted to the pediatric surgery service after completing a clinical and physical examination, and we operated after rehydration. Both underwent surgical resection with an end-to-end anastomosis. The patient was discharged uneventfully with a plan for de-worming treatment in 6 weeks.
Clinical discussion:
Ascariasis is a round intestinal worm infestation transmitted by fecal or oral contamination. Eating and excreting ascaris eggs lead to ascariasis and excrete human feces, which contaminate foods, soil, and/or water in unsanitary environments. In contrast, in the first case of this study, the diagnosis was made by ultrasound and erect abdominal radiography, and, in the second case, an abdominal ultrasound result was equivocal and required an abdominal computed tomography scan for confirmation. Treatment of small bowel obstruction by roundworms is usually surgical, but in the absence of signs of peritonitis, medical management can give effective results, even in the case of total obstruction.
Conclusion:
The type of surgery undertaken is determined by the results of the laparotomy. If the bowel was found to be intact and the obstruction was at the ileum level, milking worms to the cecum can be done with caution to avoid trauma to the bowel wall. Primary anastomosis after resection of a necrotic bowel segment and removal of the worm bolus is a suitable method for treatment of the ascariasis obstruction.
... Infection can manifest with vomiting, malnourishment, pneumonitis, growth impairment and abdominal pain. If a severe infestation occurs, it can produce, cholangitis, pancreatitis, appendicitis or even masses with intestinal obstruction and in some rare cases, perforation [1,2,4,5]. We report a case of a 55-year-old female who presented to the emergency room with abdominal tenderness and weight loss. ...
... They are swallowed again and returned to the bowel where they can reach sexual maturity [2]. Ascariasis is influenced by lifestyle, socioeconomic factors and unhygienic defecation practices [2,5,7]. While the majority of infections are asymptomatic [4], 8-15% of those infected may present with varied gastrointestinal, pulmonary, and neurological symptoms. ...
... Perforation may be due to roundworms pressing directly into the bowel wall in small spaces such as the appendix [3,7], or through an inflammatory reaction [7,9]. Diagnosis is based on the presence of adult worms or eggs in the stools [5]. Radiographs, ultrasound and CT are needed, especially when complications arise [9]. ...
Parasitic infections are still a burden in developing countries. The lack of sanitation and hygiene measures can result in an increase in morbidity and mortality due to parasitic infections. Surgery may be needed to treat serious complications caused by some of these parasites. Ascaris lumbricoides is one of the most common parasites and although infections are usually mild, severe complications, although rare, still exist. We present a case of a patient from the Ecuadorean Amazon region with limited access to drinking water. She presented to the emergency room with abdominal pain and a mass in the abdomen. After surgery, a mass with a perforation due to Ascaris was discovered. After discharge and due to lack of follow up and self-care, she became infected again, this time making her prognosis more complex and her clinical presentation more difficult. However, after proper clinical and surgical management, patient fully recovered.
... 9,10 Tumors like carcinoid and extensive intestinal ascariasis have also been reported as uncommon causes of intestinal gangrene. [11][12][13][14] In a study by Yasuhara H no aetiology was identified in 16% cases and interestingly, there was associated tuberculosis in about 20% of these cases. 10 Tuberculosis can rarely induce a hypercoagulable state by increased levels of type 1 plasminogen activator inhibitor and tissue factor. ...
We present the case of an 18 year old female with tuberculous mesenteric lymphadenopathy who came to hospital with peritonitis and acute mesenteric ischemia. An emergency exploratory laparotomy with resection of gangrenous small bowel and right colon with end-to-end anastomosis was performed. Subsequent evaluation for etiology of bowel gangrene was essentially normal. By exclusion, the most likely cause of acute mesenteric ischemia in this patient was of unknown etiology which is indeed rare. However, tuberculosis as a cause of mesenteric vasculitis and bowel gangrene needs to be explored.
... It is prevalent in tropical and subtropical climates, especially in children. [1] It may be asymptomatic or may present as acute abdomen following obstruction, gangrene or perforation of intestines. It may also masquerade as appendicular abscess. ...
... In case of fatal complications like peritonitis and intestinal gangrene, surgery is the treatment of choice. Uncomplicated cases mostly respond to oral anthelmintic drugs [1] given once at primary visit and repeated after 6 weeks. Our case was similarly managed further with albendazole on an outpatient basis. ...
Migration of Ascaris from intestine into peritoneal cavity is rare and usually presents as acute abdomen. We report a case of 41-year-old male who was admitted for laparoscopic mesh rectopexy for rectal prolapse. During the initial laparoscopy, purulent fluid was seen in pelvis. A complete diagnostic laparoscopy was done. An omental nodule was found, which was excised and extracted in a bag. On histopathology, the omental nodule revealed gravid Ascaris lumbricoides.
... Ascaris lumbricoides (A. lumbricoides), dünyada yaygın bulunan nematod olup, özellikle sıcak, ılık ve nemli tropikal bölgelerde, sanitasyon şartları bozuk yörelerde çok fazla görülmektedir (1)(2)(3)(4). İnsan dışkısının gübre olarak kullanıldığı, kişisel hijyen kurallarına uyulmayan, sosyo ekonomik düzeyin düşük olduğu bölgelerde önemli sağlık problemlerinden biridir (5,6). A. lumbricoides'in dünya genelinde 1,5 milyardan fazla insanda görüldüğü tahmin edilmektedir (2,4,7). ...
... A. lumbricoides'in dünya genelinde 1,5 milyardan fazla insanda görüldüğü tahmin edilmektedir (2,4,7). Gelişmekte olan ülkelerde her yaş grubunda görülürken, özellikle çocuklarda sık görüldüğü bildirilmektedir (3,5). Topraktaki enfektif yumurtaların doğrudan veya kontamine yiyecek ve içeceklerle ağız yoluyla alınması ile bulaş olur. ...
... Dünya genelinde yaygın olan A. lumbricoides helmint enfeksiyonuna gelişmiş ülkelerde nispeten daha az rastlanırken, olguların %80'i Asya, Afrika ve Latin Amerika'da bulunan az gelişmiş ülkelerde görülmektedir (3,12). Dünya nüfusunun yaklaşık her yıl %25'inin A. lumbricoides ile enfekte olduğu bildirilirken, ciddi Ascaris enfeksiyonlarına bağlı olarak her yıl çoğu çocuk 60000 kişi hayatını kaybetmektedir (5,13). ...
Ascaris lumbricoides is a comman intestinal helminths in humans. It is a parasite which commonly affects society with a low socioeconomic status, especially in tropical and rural areas. Ascaris lumbricoides infestation can lead to serious complications because of the mobility of the worms. The parasite can cause a variety of complications like intestinal obstruction, perforation, biliary obstruction, pancreatitis, peritonitis, liver abscess, cholangiohepatitis, volvulus, and gangrene, etc. A 59-year-old female patient hospitalized with the diagnosis of mesenteric ischemia was operated on for jejunal resection. On the 6th postoperative day, a worm was noticed emerging through the nasogastric tube. Ascaris lumbricoides was determined as a result of the examination microbiology laboratory. The patient was treated successfully with one dose of albendazole 200 mg 1x2. Our case describes a clinical situation of ascariasis observed after jejunal resection and emphasizes the importance of remaining aware of this rare complication of ascariasis. (Turkiye Parazitol Derg 2013; 37: 212-5).
... Os nematoides A. lumbricoides e T. trichura e o protozoário G. lamblia causam desde infecção assintomática a síndrome da má absorção, comprometimento do desenvolvimento físico e intelectual das crianças, diarréia crônica 11 , oclusão, perfuração intestinal e localizações ectópicas 12 . Apesar das enteroparasitoses não promoverem alta letalidade isoladamente, estas podem ser co-fatores de mortalidade infantil 13 . ...
Helminthes and enteric protozoa are serious problem of public health in developing countries. This study analyzed the prevalence of intestinal parasites in preschool children attend at basic health unities (BHS) in the city of Rio Grande, Rio Grande do Sul, Brazil. Stool samples collected from 144 children were analyzed, from October 2009 to March 2010. The observed prevalence rate for enteroparasites was 17.4 %, including eggs of nematodes Ascaris lumbricoides (11.1 %) and Trichuris trichiura (6.3 %), and cysts of protozoan Giardia lamblia (4.9 %). Also, cysts of protozoa considered as non-pathogenic, such as Entamoeba coli, Endolimax nana and Enteromonas hominis were found in 28.5 % of children. Regarding to the BHSs prevalence, in BHS-1 was detected a positivity of 36.4 %, 11.1 % in BHS-3, 14.8 % in BHS-4, 8 % in BHS-5 and 19.2 % in BHS-6. No positivity was detected in the stool samples from BHS-2. The prevalence of intestinal parasites registered in the studied population suggests the occurrence of probable conditions for re-infection, and the need to implement the basic sanitation procedures and programs which will provide an improvement in the life quality of these children.
... The rare causes of intestinal gangrene include infection 6 and infestation. [7][8][9] The histopathological report did not reveal any of these causes in this patient. Drugs that result in intestinal ischaemia and gangrene include cocaine and methamphetamine. ...
A 20-year-old primiparous woman who delivered vaginally in a private hospital 5 h ago was referred to our institute as a case of ruptured uterus. She was very pale and tachycardic with well-contracted uterus of 18-week size but had a cervical tear extending up to the left fornix. Examination under anaesthesia showed colporrhexis of posterior vaginal wall with intestines at the site of colporrhexis. Emergency laparotomy confirmed the above findings and also revealed intestinal gangrene involving more than 10 cm. Repair of colporrhexis, cervical tear and resection and anastomosis of small intestines was carried out. She gave a history of administration of five doses of vaginal misoprostal during labour and fundal pressure at the time of delivery. Literature review revealed that vaginal misoprostal can cause overgrowth of clostridial organisms by decreasing the macrophage function and thus can lead to developmental gangrene of reproductive tract and gastrointestinal tract.
The common housefly with the scientific name Musca domestica is a common pest of man known to cause nuisance, annoyance and has also been discovered to mechanically transport pathogenic microorganisms to man. Housefly is able to transmit disease to man because of its close association with man. Houseflies feed on liquid or semi-liquid food and therefore when they land on human solid food, they regurgitate liquid containing saliva and digestive juices which may contain pathogens accumulated in their esophagus from their previous feast on rotting and decaying matter such as human and animal feces. Structurally, the housefly is well suited in picking up pathogens. Housefly possesses wings therefore the continuous movement of house flies from filthy substances, such as human feces, animal excreta, carcasses, and garbage, to food makes them perfect candidate vectors for disease transmission. Several studies have shown that eggs of Ascaris lumbricoides, Trichuris trichiura, hookworm, Enterobious vermicularis, Taenia species, Hymenolepis nana, Toxocara canis, and Strongyloides stercoralis are transmitted by houseflies. Protozoan cysts and trophozoites such as Entamoeba histolytica, Giardia lamblia and bacteria such as Shigella species are also transmitted by houseflies. Houseflies can be controlled by various mechanisms which can be cultural, biological or by chemical means. KEYWORDS: Housefly; Microorganisms; Musca domestica; Pathogen;
(23) (PDF) The Role of Common Housefly as a Mechanical Vector of Pathogenic Microorganisms. Available from: https://www.researchgate.net/publication/353244566_The_Role_of_Common_Housefly_as_a_Mechanical_Vector_of_Pathogenic_Microorganisms [accessed Jul 22 2021].
Aims:
To determine the roles of the presence of malignancy, tumour proliferation fraction, vascular compromise and therapeutic and diagnostic manipulations in lymph node infarction (LNI).
Methods and results:
Thirty-five cases of LNI were identified over a 20-year period. Of the 35 patients, 31 (89%) had an underlying malignancy: 27 of the 31 (87%) were haematologic malignancies, the rest being metastatic carcinoma (two), melanoma, and seminoma. Of the four patients without evidence of malignancy, two were diagnosed with viral infection, one had LNI adjacent to a thrombosed pancreas graft, and one was lost to follow-up. Ki67 immunostaining in viable tumour demonstrated a range (5-60%) of proliferation fractions. A history of fine needle aspiration alone was present in seven of the 35 patients (20%), a history of chemotherapy alone in 11 (31%), and a history of both in two (5.7%). Factor VIII immunostaining highlighted thrombosed and recanalized vessels next to the infarction.
Conclusions:
Infarction of lymph nodes is associated with previous, concurrent or subsequent diagnosis of malignancy in the vast majority of cases. Chemotherapy or previous fine needle aspiration can precipitate infarction in some cases, but infarction may occur without such intervention, possibly because of an underlying subacute or chronic vascular compromise produced by vascular thrombosis.
