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蛔虫和手术并发症:我们在医学院附属医院的经验。

Ascaris lumbricoides and the surgical complications: our experience from Medical College Hospital.

机构信息

Department of General and Minimal Access Surgery, SKIMS Medical College, Srinagar, India.

SKIMS Medical College, Srinagar, India.

出版信息

Ir J Med Sci. 2022 Aug;191(4):1815-1821. doi: 10.1007/s11845-021-02769-y. Epub 2021 Oct 7.

Abstract

BACKGROUND

Intestinal ascariasis is considered as state subject in our valley of Kashmir. The aim of our study was to analyse the age, clinical presentation, diagnosis, surgical complications, and management of Ascaris lumbricoides in children and adults.

METHODS

Total of 312 patients above 2 years of age with definite clinical and radiological diagnosis of intestinal ascariasis and associated complications were included in our study. All our patients received anthelminthic drug (Albenzadole 400 mg stat) after termination of acute phase and attached to our Out-Patient Department for follow-up. Each patient was given second dose of antihelminthic drug at second follow-up visit.

RESULTS

Total of 312 subjects included 131 (41.99%) males and 181 (58.01%) females. The highest number of patients was in age group of 6-10 years (46.47%). Colicky abdomen pain was the most common presentation and present in 80.12% patients followed by vomiting (64.1%). Palpable worm bolus was a cardinal sign present in 46.47% of our subjects. Two-hundred sixty-five (84.94%) patients responded uneventfully and were relieved of colic and obstruction after conservative non-operative treatment. Twenty (6.41%) patients underwent enterotomy and evacuation of worms, 2 (0.64%) subjects underwent resection anastomosis, and 8 (2.56%) patients had laparotomy and milking of worms into colon. None of patient expired during the study period.

CONCLUSION

Ascaris lumbricoides is common cause of acute abdomen in our valley attributed to poor hygiene and low socioeconomic background. In patients of high clinical suspicion of worm obstruction, prompt investigations should be advised to reach a definitive diagnosis and prevent the development of complications. Significant efforts must be channelised at political and society levels for the prevention of this disease. Mass deworming programs should be adopted to overcome this menace.

摘要

背景

在我们克什米尔山谷,肠蛔虫病被认为是一种地方病。本研究旨在分析儿童和成人肠蛔虫病的年龄、临床表现、诊断、手术并发症和治疗。

方法

本研究共纳入 312 例年龄在 2 岁以上、具有明确临床和影像学诊断的肠蛔虫病及相关并发症的患者。所有患者在急性发作期结束后均接受驱虫药物(阿苯达唑 400mg 顿服)治疗,并在我院门诊随诊。每位患者在第二次随诊时接受第二剂驱虫药物治疗。

结果

共纳入 312 例患者,其中男 131 例(41.99%),女 181 例(58.01%)。年龄最大的患者为 6-10 岁,共 144 例(46.47%)。绞痛性腹痛是最常见的表现,占 80.12%,其次是呕吐(64.1%)。可触及的虫团是最主要的特征,占 46.47%。265 例(84.94%)患者经保守非手术治疗后腹痛和梗阻得到缓解,无并发症发生。20 例(6.41%)患者行肠切开取虫术,2 例(0.64%)患者行肠切除吻合术,8 例(2.56%)患者行剖腹探查和将虫挤入结肠。在研究期间,无患者死亡。

结论

在我们的山谷,由于卫生条件差和社会经济水平低,肠蛔虫病是急性腹痛的常见原因。对于高度怀疑蛔虫梗阻的患者,应及时进行检查以明确诊断并预防并发症的发生。必须在政治和社会层面上做出重大努力来预防这种疾病。应采取大规模驱虫计划来克服这一威胁。

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