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大量蛔虫病引起的小肠梗阻:两例报告

Small bowel obstruction caused by massive ascariasis: two case reports.

作者信息

Ali Abdullahi Y, Mohamed Abdi Abdishakur, Mambet Ervin

机构信息

Department of the Pediatric Surgery, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia.

出版信息

Ann Med Surg (Lond). 2023 Feb 6;85(3):486-489. doi: 10.1097/MS9.0000000000000224. eCollection 2023 Mar.

Abstract

UNLABELLED

is an infestation that affects approximately one-seventh of the world's population. is a common inhabitant of the intestines of people with low-socioeconomic incomes, especially in underdeveloped countries of the world. infestation is more prone to infestation with serious complications such as intestinal obstruction, volvulus, intussusception, and intestinal necrosis at higher rates in children than in adults.

CASE PRESENTATION

The authors present here two cases of small bowel obstruction caused by massive that were admitted to the pediatric surgery service after completing a clinical and physical examination, and we operated after rehydration. Both underwent surgical resection with an end-to-end anastomosis. The patient was discharged uneventfully with a plan for de-worming treatment in 6 weeks.

CLINICAL DISCUSSION

Ascariasis is a round intestinal worm infestation transmitted by fecal or oral contamination. Eating and excreting ascaris eggs lead to ascariasis and excrete human feces, which contaminate foods, soil, and/or water in unsanitary environments. In contrast, in the first case of this study, the diagnosis was made by ultrasound and erect abdominal radiography, and, in the second case, an abdominal ultrasound result was equivocal and required an abdominal computed tomography scan for confirmation. Treatment of small bowel obstruction by roundworms is usually surgical, but in the absence of signs of peritonitis, medical management can give effective results, even in the case of total obstruction.

CONCLUSION

The type of surgery undertaken is determined by the results of the laparotomy. If the bowel was found to be intact and the obstruction was at the ileum level, milking worms to the cecum can be done with caution to avoid trauma to the bowel wall. Primary anastomosis after resection of a necrotic bowel segment and removal of the worm bolus is a suitable method for treatment of the ascariasis obstruction.

摘要

未标注

蛔虫感染影响着世界约七分之一的人口。蛔虫是社会经济收入较低人群肠道中的常见寄生虫,尤其在世界上的不发达国家。蛔虫感染在儿童中比在成人中更易引发严重并发症,如肠梗阻、肠扭转、肠套叠和肠坏死。

病例报告

作者在此介绍两例因大量蛔虫导致小肠梗阻的病例,患儿经临床和体格检查后入住小儿外科,补液后进行了手术。两例均接受了肠切除端端吻合术。患者顺利出院,计划在6周后进行驱虫治疗。

临床讨论

蛔虫病是一种通过粪口污染传播的肠道蛔虫感染。摄入和排出蛔虫卵会导致蛔虫病,并排出人类粪便,这些粪便会在不卫生的环境中污染食物、土壤和/或水。相比之下,在本研究的第一例中,通过超声和立位腹部X线摄影做出诊断,而在第二例中,腹部超声结果不明确,需要进行腹部计算机断层扫描以确诊。蛔虫引起的小肠梗阻通常采用手术治疗,但在没有腹膜炎体征的情况下,即使是完全梗阻,药物治疗也可能取得有效结果。

结论

所进行的手术类型取决于剖腹探查的结果。如果发现肠管完整且梗阻位于回肠水平,可以谨慎地将蛔虫挤向盲肠,以避免损伤肠壁。切除坏死肠段并取出蛔虫团块后进行一期吻合是治疗蛔虫梗阻的合适方法。

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