Bhagwat Aniruddha D, Patil Rashmi, Makan Apoorva, Vaze Dhananjay, Jadhav Pranav
Department of Pediatric Surgery, Dr. D.Y. Patil Medical College, Hospital and Research Centre, PCMC, affiliated to Dr. D.Y. Patil Vidyapeeth, Deemed to be University, Pune, 411018 MS India.
J Parasit Dis. 2025 Jun;49(2):368-377. doi: 10.1007/s12639-024-01764-1. Epub 2024 Nov 13.
Intestinal perforations by worms are rare. Ascariasis is the commonest helminthic infestation in the world. Ascariasis must be considered as a differential diagnosis in intestinal obstruction and perforation especially in endemic regions. The clinical presentation can vary from an asymptomatic patient to severe complicated disease. Symptoms depend on the intestinal worm load and intestinal obstruction is a common complication. Because of the rarity of helminthic intestinal perforations and more so given the large-scale migration from developing countries, we wish to emphasize the need to inculcate awareness among treating clinicians, even from the developed world, about this potentially dangerous yet treatable condition. Early diagnosis and treatment is crucial to prevent significant mortality and morbidity from disease complications. Conservative treatment is advised for uncomplicated intestinal Ascariasis. Surgery is life saving in Ascaris complications. There is no effective vaccine available till date. Prevention is better than cure. We present a case series analysis of five children with worm infestation and intestinal perforation, and report clinical presentations, imaging modalities used, treatment and outcomes for each of the case.
蠕虫导致的肠穿孔很少见。蛔虫病是世界上最常见的蠕虫感染。在肠梗阻和肠穿孔的鉴别诊断中必须考虑蛔虫病，尤其是在流行地区。临床表现从无症状患者到严重的复杂疾病不等。症状取决于肠道蠕虫负荷，肠梗阻是常见并发症。由于蠕虫性肠穿孔罕见，而且鉴于有大量人口从发展中国家迁移，我们希望强调，即使是发达国家的临床治疗医生，也需要对这种潜在危险但可治疗的疾病提高认识。早期诊断和治疗对于预防疾病并发症导致的重大死亡率和发病率至关重要。对于无并发症的肠道蛔虫病，建议采用保守治疗。手术对蛔虫并发症有挽救生命的作用。迄今为止，尚无有效的疫苗。预防胜于治疗。我们对五例有蠕虫感染和肠穿孔的儿童进行了病例系列分析，并报告了每个病例的临床表现、使用的成像方式、治疗方法和结果。
