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ABC of Pediatric Surgical ImagingAscariasis (Worm Bolus Obstruction)

ABC of Pediatric Surgical Imaging: Ascariasis (Worm Bolus Obstruction) Surgeon: M. Arnold, J. Alves A Ascariasis (Worm Bolus Obstruction) Radiologist: J. du Plessis Clinical Diff erential Diagnosis Clinical Insights Other causes of bowel and pancreatico- Ascaris worms colonise 20–25% of biliary duct obstruction. world’s population. Sand ingestion (pica) may resemble May present with: worms on abdominal X-ray. - Vague abdominal complaints. - Evidence of malabsorption. - Bowel obstruction due to a worm bolus. - Biliary colic. - Cholangitis or pancreatitis. Warnings A worm bolus may cause obstruction or volvulus. Worm bolus obstruction with fl uid levels M on X-ray usually indicates impending strangulation/necrosis. This clinical and radiological picture in Ascaris worms “milked” from bowel during surgery the presence of a tender or peritonitic for bolus obstruction abdomen requires urgent surgical intervention. What the Surgeon Needs to Know Is there a worm infestation? Are the worms the likely cause of the symptoms? Are there worms in the biliary tree? Plain abdominal fi lm demonstrates a whorled appear- ance of the worms outlined by air 12 Ascariasis (Worm Bolus Obstruction) – Surgical Aspects Imaging Options Primary: AXR Back-up: US, CT, contrast fl uoroscopy ⚉ Imaging Findings AXR Partial or complete bowel obstruction with distended bowel loops Whorled appearance US of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

ABC of Pediatric Surgical ImagingAscariasis (Worm Bolus Obstruction)

Editors: Andronikou, Savvas; Alexander, Angus; Kilborn, Tracy; Millar, Alastair J. W.; Daneman, Alan
Arnold, M.; Alves, J.; Plessis, J. du
Springer Journals — Jan 1, 2010
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Publisher
Springer Berlin Heidelberg
Copyright
© Springer-Verlag Berlin Heidelberg 2010
ISBN
978-3-540-89384-4
Pages
12 –13
DOI
10.1007/978-3-540-89385-1_6
Publisher site
See Chapter on Publisher Site

Abstract

Surgeon: M. Arnold, J. Alves A Ascariasis (Worm Bolus Obstruction) Radiologist: J. du Plessis Clinical Diff erential Diagnosis Clinical Insights Other causes of bowel and pancreatico- Ascaris worms colonise 20–25% of biliary duct obstruction. world’s population. Sand ingestion (pica) may resemble May present with: worms on abdominal X-ray. - Vague abdominal complaints. - Evidence of malabsorption. - Bowel obstruction due to a worm bolus. - Biliary colic. - Cholangitis or pancreatitis. Warnings A worm bolus may cause obstruction or volvulus. Worm bolus obstruction with fl uid levels M on X-ray usually indicates impending strangulation/necrosis. This clinical and radiological picture in Ascaris worms “milked” from bowel during surgery the presence of a tender or peritonitic for bolus obstruction abdomen requires urgent surgical intervention. What the Surgeon Needs to Know Is there a worm infestation? Are the worms the likely cause of the symptoms? Are there worms in the biliary tree? Plain abdominal fi lm demonstrates a whorled appear- ance of the worms outlined by air 12 Ascariasis (Worm Bolus Obstruction) – Surgical Aspects Imaging Options Primary: AXR Back-up: US, CT, contrast fl uoroscopy ⚉ Imaging Findings AXR Partial or complete bowel obstruction with distended bowel loops Whorled appearance US of

Published: Jan 1, 2010

Keywords: Bowel Obstruction; Distended Bowel; Biliary Colic; Urgent Surgical Intervention; Radiological Picture

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