Ascaris lumbricoides causing acute abdomen: a case report.

Ascaris lumbricoides is one of the most well-known helminthic parasites affecting humans, and ascariasis remains common with > 1.2 billion infections globally [1]. It is endemic in the Middle East and South America especially in under-developed countries where poor sanitation, the most important risk factor for infection [2], is common [3]. A. lumbricoides infection occurs in all age groups but more commonly in preschool children [4]. Although ascariasis cases are usually asymptomatic, infection leads to malnutrition in children and causes about 3000–60 000 deaths every year, usually as a result of intestinal obstruction [5–7]. The most common causes of acute abdomen are acute appendicitis, acute peptic ulcer, acute cholecystitis, acute pancreatitis, intestinal obstruction, acute peritonitis and acute pyelonephritis [8]. One cause of intestinal obstruction by parasites is A. lumbricoides infection. The most commonly known serious and lethal complication of A. lumbricoides infection is intestinal obstruction, caused by an aggregated mass of A. lumbricoides worms, which may develop acutely or subacutely [9]. Early diagnosis of intestinal obstruction caused by A. lumbricoides using ultrasonography is very useful to avoid its serious and lethal complications [10]. Emergency surgical treatment may be necessary in acute intestinal obstruction in which the mass of the parasite obstructs the intestinal lumen or intestinal obstruction develops due to volvulus [11]. Meanwhile, subacute cases are successfully treated conservatively until spontaneous resolution [3,12]. The aim of this report is to present a case of bowel obstruction caused by A. lumbricoides as a cause of acute abdomen in one governorate in Egypt.