In patients with ascariasis a variety of factors may cause the ascarids to migrate. Occasionally the worms may migrate together to form a mass in the intestine which can result in partial or complete obstruction. Conservative management of the patient may allow the obstruction to reverse itself, while administration of an antihelmintic agent may precipitate a complete obstruction. The study population was from Erzurum, Turkey.
Factors affecting worm migration:
(1) high fever
(2) diarrhea
(3) peppery foods
(4) medications and anesthetic agents
Diagnosis of intestinal ascariasis:
(1) previous history of passages of worms
(2) vomiting of worms
(3) palpation of bolus of worms
(4) palpation of worms during digital rectal examination
(5) detection of a mass of worms on abdominal radiographs
Findings
Partial Obstruction
Complete Obstruction
dehydration
no
yes
temperature
<= 37.5°C
> 37.5°C
abdominal distention and tenderness
none to minimal
present
erect abdominal plain film X-rays
narrow-based air-fluid levels without distended loops of bowel
wide-based air-fluid levels with distended loops of bowel
Patients with complete obstruction may require surgery to relieve the obstruction, reverse and intussusception or to resect infarcted portions of bowel.
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