Surgical management of worm volvulus.
A retrospective study of 50 consecutive patients with small-bowel volvulus complicating intestinal ascariasis is reported. The commonest presenting features were abdominal distension (44 patients) and abdominal pain (38 patients). Thirty-three patients presented with vomiting, of whom 8 vomited worms. Twenty-five patients presented with peritonitis. In 33 patients there was evidence of worm infestation on radiographs while volvulus was diagnosed radiographically in 16 patients. Thirty-two patients required emergency surgery, while 16 were observed for a mean of 2.6 days before surgery. Thirty-nine patients had gangrenous bowel that required resection. The overall mortality rate was 14.5% and all deaths were from the gangrenous group. The results show that volvulus complicating ascariasis still carries a high mortality and morbidity rate. We stress the importance of early detection and early operative intervention.
Madiba
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TE
Department of General Surgery, University of Natal, Durban.
Hadley
G P
GP
D001196:Ascariasis / Q000150:complications / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007411:Intestinal Diseases, Parasitic / Q000150:complications / Q000601:surgery*; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D013019:South Africa; D016896:Treatment Outcome