Fatemiyoun Seyed Abbas, Rafiei Farzad, Sheikhalishahi Seyed Shahab Adin
Department of General Surgery Shahid Sadoughi University of Medical Sciences Yazd Iran.
Student Research Committee Shahid Sadoughi University of Medical Sciences Yazd Iran.
Clin Case Rep. 2025 May 20;13(5):e70524. doi: 10.1002/ccr3.70524. eCollection 2025 May.
Intestinal obstruction caused by Ascaris lumbricoides (AL) is rare but clinically significant, particularly in endemic regions. We report an 18-year-old Afghan male who presented with a two-month history of intermittent right lower quadrant pain, worsening over the past week with anorexia, constipation, nausea, and fatigue. Examination revealed generalized abdominal tenderness, involuntary guarding, and silent bowel sounds, suggesting an acute abdomen. Initial diagnosis was complicated appendicitis. After stabilization, laparotomy revealed a small bowel obstruction caused by a mass of AL, which was relieved via enterotomy and bowel repair. An incidental appendectomy was performed. Postoperatively, the patient was treated with albendazole and mebendazole. Bowel function returned by postoperative day three, and he was discharged on day five in stable condition. At one-week follow-up, he was asymptomatic with no complications. This case highlights the diagnostic challenges of parasitic infections, especially in non-endemic areas, and emphasizes the importance of early imaging, timely surgical intervention, and comprehensive management. Clinicians should maintain a high index of suspicion for parasitic causes in bowel obstruction cases, particularly in endemic populations, to ensure prompt diagnosis and optimal outcomes.
蛔虫引起的肠梗阻较为罕见，但在临床上具有重要意义，尤其是在流行地区。我们报告了一名18岁的阿富汗男性，他有两个月的间歇性右下腹疼痛病史，在过去一周病情加重，伴有厌食、便秘、恶心和疲劳。检查发现全腹压痛、肌紧张和肠鸣音消失，提示急腹症。初步诊断为复杂性阑尾炎。病情稳定后，剖腹探查发现小肠被一团蛔虫阻塞，通过肠切开术和肠修复解除了梗阻。同时进行了阑尾切除术。术后，患者接受了阿苯达唑和甲苯达唑治疗。术后第三天肠道功能恢复，患者于第五天病情稳定出院。在一周的随访中，他没有症状，也没有并发症。该病例突出了寄生虫感染的诊断挑战，尤其是在非流行地区，并强调了早期影像学检查、及时手术干预和综合管理的重要性。临床医生在肠梗阻病例中，尤其是在流行地区人群中，应高度怀疑寄生虫病因，以确保及时诊断和最佳治疗效果。
