Exploring Surgical Interventions for Gastrointestinal and HepatoPancreato-Biliary Ascariasis
Authors/Creators
- 1. Assistant Professor, Department of General Surgery, Geetanjali Medical College and Hospital Udaipur, Rajasthan, India
Description
Background and Aim: Ascariasis is the most common helminthic disease in humans. It has global distribution and is most prevalent in tropical countries where the temperature and humidity favor the development of eggs in the soil. Ascaris is transmitted through fecal-oral route. Most of the affected are asymptomatic or present with nonspecific abdominal symptoms. However, because of the high prevalence of infection, complications can occur such as intestinal obstruction due to massive infestation, biliary colic, gallstone formation, cholecytitis, liver abscess recurrent pyogenic cholangitis and pancreatitis. Material and Methods: Patients presented to the hospital with hepatopancreatobiliary and gastrointestinal ascariasis during the study period was included after taking due informed consent. A total of 100 adult patients were enrolled in the study. A detailed clinical history was taken from all the patients. Ultrasonography of whole abdomen was done in all patients. X-ray abdomen in erect and/or supine posture was done in patients presenting with features of intestinal obstruction. Upper gastrointestinal endoscopy was done in some patients. Results: The patterns of diseases could be classified into 4 broad categories namely: biliary colic, acute pancreatitis, acute cholangitis and intestinal obstruction. Ninety percent of patients (90/100) could be managed successfully conservatively. Endoscopic removal of worms from biliary tract was done successfully in 6 patients. 4 patients underwent surgery for unrelenting cholangitis due to dead worms in the common bile duct. Conclusion: Gastrointestinal and hepatopancreatobiliary ascariasis has a high disease burden in study area. The disease reflects sanitation habits of the population and has a wide spectrum of manifestations. Management is predominantly conservative and the prognosis good. Sanitary habits should be advised and the family dewormed if an index case of ascariasis is found in the population.
Abstract (English)
Background and Aim: Ascariasis is the most common helminthic disease in humans. It has global distribution and is most prevalent in tropical countries where the temperature and humidity favor the development of eggs in the soil. Ascaris is transmitted through fecal-oral route. Most of the affected are asymptomatic or present with nonspecific abdominal symptoms. However, because of the high prevalence of infection, complications can occur such as intestinal obstruction due to massive infestation, biliary colic, gallstone formation, cholecytitis, liver abscess recurrent pyogenic cholangitis and pancreatitis. Material and Methods: Patients presented to the hospital with hepatopancreatobiliary and gastrointestinal ascariasis during the study period was included after taking due informed consent. A total of 100 adult patients were enrolled in the study. A detailed clinical history was taken from all the patients. Ultrasonography of whole abdomen was done in all patients. X-ray abdomen in erect and/or supine posture was done in patients presenting with features of intestinal obstruction. Upper gastrointestinal endoscopy was done in some patients. Results: The patterns of diseases could be classified into 4 broad categories namely: biliary colic, acute pancreatitis, acute cholangitis and intestinal obstruction. Ninety percent of patients (90/100) could be managed successfully conservatively. Endoscopic removal of worms from biliary tract was done successfully in 6 patients. 4 patients underwent surgery for unrelenting cholangitis due to dead worms in the common bile duct. Conclusion: Gastrointestinal and hepatopancreatobiliary ascariasis has a high disease burden in study area. The disease reflects sanitation habits of the population and has a wide spectrum of manifestations. Management is predominantly conservative and the prognosis good. Sanitary habits should be advised and the family dewormed if an index case of ascariasis is found in the population.
Files
IJPCR,Vol16,Issue9,Article56.pdf
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Additional details
Dates
- Accepted
-
2024-08-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue9,Article56.pdf
- Development Status
- Active
References
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