title: Surgical complications of Ascaris lumbricoides in children.
abstract: OBJECTIVE
  To report the surgical complications of Ascaris lumbricoides infestation in children.
  
  
  METHODS
  This is a retrospective study and cases of intestinal ascariasis managed conservatively were excluded.
  
  
  RESULTS
  Sixteen children presented with Ascariasis sequelae, which included ileal volvulus (n=5), perforations (n=4), intussusception (n=1), biliary ascariasis (n-1) and impacted multiple worm boluses (n=5). Plain abdominal radiographs showed pneumoperitoneum (3), cigar bundle appearance (3) and multiple air and fluid levels (13). Sonography showed floating worms with free fluid (2), sluggish peristalsis and moderate free fluid (7) and intestinal worm bolus (11). The surgical procedures included milking of worms (in all), bowel resection (6), closure of perforation (3) and manual reduction of intussusception (1). Biliary ascariasis was managed conservatively and the progress monitored with sonography. There were 3 deaths all of whom had intestinal volvulus, bowel necrosis and toxemia.
  
  
  CONCLUSIONS
  Sonography can be helpful in diagnosing the presence of worms, its complications and in evaluating response to treatment. Early surgical intervention in those with worm bolus, peritonism, and volvulus may salvage bowel and reduce mortality.
authors.affiliation: Department of Paediatric Surgery, Vani Vilas Hospital, Bangalore Medical College and Research Institute, Bangalore, India.
authors.forename: Raghu S
authors.initials: RS
authors.lastname: Ramareddy
authors.forename: Anand
authors.initials: A
authors.lastname: Alladi
authors.forename: O S
authors.initials: OS
authors.lastname: Siddapa
authors.forename: V
authors.initials: V
authors.lastname: Deepti
authors.forename: Tanveer
authors.initials: T
authors.lastname: Akthar
authors.forename: B
authors.initials: B
authors.lastname: Mamata