Ascariasis - Removing worms from Patient's duodenum Endoscopically Dr. Tayyab Saeed Akhtar

This is the story of a 30 year old female patient who had recurrent abdominal pain for 3-4 months with no other obvious signs or symptoms.

Her basic workup was normal.

She underwent upper GI endoscopy.

What is Ascariasis?

Ascariasis is an infection of the human intestine caused by a worm or parasite called Ascaris lumbricoides (A. lumbricoides), which is a species of parasites called roundworms.

Ascariasis is the commonest human parasitic intestinal infection. About 10% of the developing world which includes population of almost all of the south Asian countries, is infected with intestinal worms, according to the records of World Health Organization (WHO).

Ascariasis is most common in places without modern sanitation. It’s transmitted through uncooked, or non-sterile/boiled food and water.

What causes Ascariasis? 

You can become infected with ascariasis after ingesting the eggs of the A. lumbricoides roundworm by any mean. The eggs are usually found in soil contaminated by human feces or uncooked food contaminated by soil or a person (by unwashed hands etc) that contains roundworm eggs. Children often become infected when they put their hands in their mouths after playing in contaminated soil or using toilet. Ascariasis can also be passed directly from person-to-person.

What are the symptoms of Ascariasis? 

Symptoms doesn't usually appear during the early stages of infestation. You may notice more symptoms later when the roundworm infestation grows

Roundworms in your lungs can cause:

coughing or gagging

vomiting, parasite may be present in the vomitus

wheezing or SOB (shortness of breath)

Roundworms in your intestines can cause:

nausea, 

vomiting

irregular stools, diarrhea

Worms in the stool

stomach or abdominal pain

weight loss

What Are the Complications of Ascariasis?

Intestinal obstruction occurs when a mass of worms blocks your intestines causing severe pain and vomiting. Intestinal obstruction of blockage is considered a medical emergency and requires prompt treatment, which may include surgery or endoscopic removal. 

Duct obstruction occurs when the worms block the passageways to your liver or pancreas, this may lead to complications such as jaundice or pancreatitis. 

Infections that lead to anorexia and malabsorption can cause delayed growth and malnutrition. This puts children at risk of not getting enough nutrients, which can affect their physical and mental growth

This article is peer reviewed by: 

Dr. Adil Ramzan