Massive gastrointestinal bleeding in infants with ascariasis

Sangkhathat, Surasak; Patrapinyokul, Sakda; Wudhisuthimethawee, Prasit; Chedphaopan, Jerawan; Mitamun, Winyou

doi:10.1016/s0022-3468(03)00584-0

Cited by 28 publications

(11 citation statements)

References 8 publications

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“…Massive gastrointestinal bleeding is a rare complication of ascaris intestinal obstruction reported in two infants who presented with massive hematemesis [21]. The rate of mortality in ascaris intestinal obstruction in children more than 10 years of age is 5.7% [20].…”

Section: Discussionmentioning

confidence: 99%

A rare case of intestinal obstruction due to ascariasis in Niš, south Serbia

et al. 2011

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AbstractAscariasis is a helminthic infection of global distribution, and intestinal obstruction is its most common gastrointestinal complication. This is a case of a 7-year-old boy admitted to Pediatric Surgery because of intestinal obstruction caused by ascariasis. On admission, the patient presented with colicky abdominal pain, bile-stained vomiting and meteorism. On physical examination, the patient was thin, pale, and dehydrated. An abdominal examination showed distention and diffuse tenderness. After admission, the patient had fecal vomiting and expulsion of worms through the mouth. Laboratory-test results showed leucocytosis, eosinophilia, hypoalbuminaemia, and hypochloremia. Abdominal radiographs and ultrasound studies were indicative of small-bowel obstruction due to roundworms, which led to the performance of an exploratory laparotomy. On bowel exploration, an intraluminal mass, 10 by 6 cm in diameter, consisting of roundworms in the middle third of the ileum was found. A longitudinal enterotomy was performed, and the worms were meticulously extracted manually. Postoperatively, broad-spectrum antibiotics and antihelminthic drugs were administered. Our case of intestinal obstruction caused by ascariasis is the first to be reported in Serbia, according to the Serbian literature.

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Section: Discussionmentioning

confidence: 99%

A rare case of intestinal obstruction due to ascariasis in Niš, south Serbia

et al. 2011

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“…Thus, even in haemostatically normal hosts, the hook worm is reported to induce a wide spectrum of gastrointestinal haemorrhages, ranging from occult blood loss to melena and frank haematochezia, all of which are associated with iron deficiency [19][20][21][22] . Moreover, Ascaris lumbricoides has been associated with haematochezia, haematemesis and iron deficiency, even in haemostatically normal hosts [23][24][25] . Similarly, Trichuris trichiura is capable of inducing both occult and frank gastrointestinal haemorrhage in the form of haematochezia, as well as iron deficiency, even in haemostatically normal hosts [26][27][28] .…”

Section: Discussionmentioning

confidence: 99%

Impact of intestinal helminths on the risks of gastrointestinal haemorrhage and iron deficiency among haemophilia patients in northern Nigeria

Ibrahim

Ahmed

Kagu

et al. 2017

The Journal of Haemophilia Practice

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We predicted that haemophilia would create a prohaemorrhagic host-parasite relationship, which would make haemophiliacs very vulnerable to haemorrhagic effects of intestinal helminths in tropical countries like Nigeria. If our prediction is correct, the frequency and risks of gastrointestinal haemorrhage and iron deficiency will be higher among haemophiliacs infected by helminths in comparison with uninfected haemophiliacs. Frequency of gastrointestinal haemorrhages and iron deficiency among haemophiliacs with and without intestinal helminth infections were retrospectively obtained and analysed, and their relative risk determined by regression analysis. Haemophiliacs with intestinal helminths had significantly higher frequencies of gastrointestinal haemorrhage (73.3% vs. 18.5%, p<0.05) and iron deficiency (60% vs. 22.2%, p<0.05) in comparison with haemophiliacs without intestinal helminths. Haemophiliacs with intestinal helminths had significantly elevated relative risks (RR) of gastrointestinal haemorrhage (RR=3.4, CI95%: 2.4- 4.3, p=0.007) and iron deficiency (RR=2.5, CI95%: 1.7-3.3, p=0.009). These results showed that helminth infections were associated with increased risks of gastrointestinal haemorrhage and iron deficiency in haemophiliacs. This is thought to be due to a pro-haemorrhagic host-parasite relationship resulting from host haemostatic abnormality, coupled with the concurrent manipulation of the host haemostatic system by anticoagulants produced by some of the parasites. Haemophiliacs in tropical countries should be regularly screened and treated for intestinal helminths.

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“…Only a limited number of intestinal gangrene cases due to torsion of bowel as a result of extensive intestinal ascariasis has been reported in the past [13], [18], [19]. But none of them has reported the associated infarction of the mesenteric lymph nodes.…”

Section: Discussionmentioning

confidence: 99%