Insurgence of Maggots Around Colostomy: An Unusual Presentation

Abstract

ABSTRACT:Insurgence of Maggot's is an uncommon feature of colostomy site. Maggots' infestation has been reported over sites like nose, ear, orbit, tracheotomy wound, face, gums and serous cavities. We report a case of maggots infestation surrounding the colostomy site, which to the best of our knowledge, is the first reported case in the review of the literature. A patient of advanced inoperable adenocarcinoma rectum presented with complaints of constant vague pain, discomfort and foul smelling discharge over colostomy site. On exploration, maggots were identified as the cause and patient was relieved of his agony by their meticulous eradication. We emphasize that Stoma Care should be constantly monitored to prevent Maggot infestation and prevention counseling should be included in the stoma care protocol in tropical countries.

Maggots Around Colostomy Site: A Case Report

“…1 Colostomy treatment is a critical aspect of post-operative care, but it is often overlooked by patients and their families in developing countries. 3 Socioeconomic factors such as advanced age, lack of sanitation, prior diabetes, rural housing, homelessness, neurological disorders are linked to disease risk factors. 2 Debridement, larvae and devitalized tissue removal are often used in conjunction with the administration of Ivermectin and antibiotics.…”

“…Inflammation and toxin are the causes of pathogenicity. 3 Various authors advocate that occlusion/suffocation methods force the larva to come out, which are then caught with tweezers (or forceps). The occluding materials such as turpentine oil, petroleum jelly, liquid paraffin, beeswax or heavy oil, or lard or bacon strips are usually positioned over the central punctum to coax the larva to emerge head first.…”

“…We need to be careful not to rupture the maggots, as this could result in secondary infections or a potentially serious allergic reaction. 3 In this case the usual method of suffocation with turpentine oil was used to force larva to emerge on surface and maggots were removed using artery forceps.…”

“…2 Infestation is common in tropical areas including Nepal. 3 Patients have a variety of risk factors and comorbidities that make them more susceptible to this condition.…”