title: Intestinal Obstruction in a 3-Year-Old Girl by Ascaris lumbricoides Infestation: Case Report and Review of the Literature.
abstract: Ascaris lumbricoides infection affects approximately 1.5 billion people globally. Children with environmental and socio-economic risk factors are more susceptible to infestation, with serious complications such as intestinal obstruction (IO), volvulus, intussusception, and intestinal necrosis.We present the case of a 3-year-old girl who arrived at emergency department with abdominal pain and diarrhea for the last 3 days. The previous day she took an unspecified anthelmintic. Symptoms worsened with vomiting and diarrhea, with expulsion of roundworms through mouth and anus. Physical examination revealed bloating, absence of bowel sounds, abdominal tenderness, and a palpable mass in right hemi-abdomen. Abdominal radiographs showed air-fluid levels with mild bowel distention and shadows of roundworms. The diagnosis of IO by A lumbricoides. infestation was established and surgical approach scheduled. During exploratory laparotomy an intraluminal bolus of roundworms from jejunum to ascendant colon was evident. An ileum enterotomy was performed and worms were removed. Fluid therapy and antibiotics for 72  hours were administered, with posterior albendazol treatment for 3 days. Patient was uneventfully discharged on the tenth day.Reduction in parasitic load by means of improvements in sanitation, health education, and anthelmintic treatment must be implemented in endemic zones to prevent serious life-threatening complications by A lumbricoides. infestation, because some of them require urgent surgical treatment.
authors.affiliation: From the General Surgery Department, Instituto Mexicano del Seguro Social, Hospital General Regional No. 17. Cancún, Quintana Roo, (AMA, YP, CL, SSC); Applied Biotechnique Department, Instituto Nacional de Cardiología Ignacio Chavez. Distrito Federal, México (AMA, GOR); and Internal Medicine Department, Hospital de Especialidades, Distrito Federal, México (LMA).
authors.forename: Angel Medina
authors.initials: AM
authors.lastname: Andrade
authors.forename: Yeudiel
authors.initials: Y
authors.lastname: Perez
authors.forename: Cecilia
authors.initials: C
authors.lastname: Lopez
authors.forename: Stephanie Serrano
authors.initials: SS
authors.lastname: Collazos
authors.forename: Alejandro Medina
authors.initials: AM
authors.lastname: Andrade
authors.forename: Grecia Ortiz
authors.initials: GO
authors.lastname: Ramirez
authors.forename: Laura Medina
authors.initials: LM
authors.lastname: Andrade
mesh_terms: D000818:Animals; D001196:Ascariasis / Q000150:complications*; D017164:Ascaris lumbricoides; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011859:Radiography; D012307:Risk Factors