Case Report
IntestinalObstructioninaChildwithMassiveAscariasis
MunanuraTuryasiima ,
1,2
PaulMatovu,
3
GloriaKiconco ,
1,2
WalufuIvanEgesa ,
2
PhillipSunday,
3
LydiaNakandi,
3
KiryaMusa,
3
DenisOluka,
3
andMartinByendera
3
1
Pediatrics and Child Health Department, Kisiizi Hospital Church of Uganda, Kabale, Uganda
2
Pediatrics and Child Health Department, Kampala International University, Western Campus, Bushenyi, Uganda
3
Surgery Department, Kisiizi Hospital Church of Uganda, Kabale, Uganda
Correspondence should be addressed to Munanura Turyasiima; tumiek2000@gmail.com
Received 18 September 2020; Revised 19 December 2020; Accepted 23 December 2020; Published 8 January 2021
Academic Editor: Maria Moschovi
Copyright © 2021 Munanura Turyasiima et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Soil-transmitted helminths are so prevalent in the tropics and low developing countries. Pediatric clinical presentation of as-
cariasis, the most common helminth, as the intestinal obstruction is not only rare but also less described. We present a case of a 4-
year-old girl with massive ascariasis. She presented with a 3-day history of acute abdominal pain associated with vomiting and an
episode of passing long white roundworms, about 5 cm in length, through the nose. e child had mild constipation and passed
pellets of hard stool once in the last 72 hours. She was in fair general condition at the examination but had significant findings on
abdominal examination. On palpation, there was a soft mass localized in the left paraumbilical area and no tenderness, with
normal bowel sounds on auscultation. Exploratory laparotomy was sanctioned where roundworms (Ascaris lumbricoides),
saucepan full, were delivered through a 2.5 cm enterotomy incision. Postoperative management was carried out, and the child
discharged on the 7
th
day of treatment including a 3-day course of albendazole 400 mg daily.
1.Introduction
Soil-transmitted helminths (STH) infect about 1.5 billion
people worldwide [1] and cause short- and long-term effects,
especially among children. Ascaris lumbricoides is among the
most prevalent of all other different species of the STH in
most parts of the world including Uganda [2–5]. We present
a child who presented with an acute intestinal obstruction
that was at admission misdiagnosed as intestinal intussus-
ception, but later discovered to have massive ascariasis
during an exploratory laparotomy.
2.CasePresentation
2.1. Sociodemographic Information. A. L is a 4-year-old girl
from Nyakishenyi subcounty, Rukungiri district, a rural
remote setting in southwestern Uganda, who was admitted
to the pediatric ward of Kisiizi Hospital, in July 2020.
2.2. History. She presented with a 3-day history of ab-
dominal pain and vomiting episodes. e abdominal pain
was of gradual onset, severe, and localized in the umbilical
area, radiating to the lower abdomen. She had three vom-
iting episodes that were nonbilious, containing food con-
tents, and could occasionally pass out long white
roundworms, about 5 cm in length through the nose. She
had mild constipation, passing pellets of hard stool. She also
reported on and off low-grade fever. e other system re-
views were unremarkable. She had no chronic medical
disease and was HIV/AIDs negative. e child had been only
dewormed once in the last 18 months. Growth and devel-
opment milestones were normal according to the mother.
2.3. Physical Examination. We examined a preschool-going
girl in a fair general condition, afebrile (axillary temperature
of 36.7
°
C), not in distress, with no pallor, no
Hindawi
Case Reports in Pediatrics
Volume 2021, Article ID 8857291, 4 pages
https://doi.org/10.1155/2021/8857291