Ascariasis surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]

Overview

Ascariasis is usually managed conservatively with medical therapy but surgery may be indicated when medical management fails or complications arise.[1]

Surgery

Some of the indications for the surgical management of ascariasis include:[1]

Surgical therapy

Hepatobiliary ascariasis

The surgical management for hepatobiliary infestation with ascaris include:[2]

  • Endoscopic management: This entails endoscopic extraction of the worm

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Intestinal obstruction due to ascariasis

Intestinal obstruction from ascariasis can be surgically managed via the following methods:[3][1]

  • External "milking" of the obstructing bolus of worms from the ileum into the colon
  • Enterotomy to manually extract the worms
Images courtesy of Dr. Imtiaz Ahmed Wani
  • Intestinal resection and end-to-end anastomosis if necessary
Resected gangrenous loop of bowel during surgery in a child with intestinal obstruction from Ascaris lumbricoides - Images courtesy of Dr. Imtiaz Ahmed Wani

References

  1. 1.0 1.1 1.2 Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.
  2. Astudillo JA, Sporn E, Serrano B, Astudillo R (2008). "Ascariasis in the hepatobiliary system: laparoscopic management". J Am Coll Surg. 207 (4): 527–32. doi:10.1016/j.jamcollsurg.2008.05.020. PMID 18926454.
  3. Villamizar E, Méndez M, Bonilla E, Varon H, de Onatra S (1996). "Ascaris lumbricoides infestation as a cause of intestinal obstruction in children: experience with 87 cases". J Pediatr Surg. 31 (1): 201–4, discussion 204-5. PMID 8632280.