Small bowel intussusception andEnterobius vermicularisinfestation in a 20-year-old woman

Abstract

A 20-year-old woman presented with abdominal pain and MRI findings of intussusception of the distal small bowel with no identifiable lead point and no visualisation of the appendix. A diagnostic laparoscopy succeeded in manually reducing the intussusception but was unable to find any candidate lead point. Intraoperatively, hyperperistalsis was observed throughout the small bowel which seemed prone to transient intussusception. Incidental appendectomy revealed an uninflamed appendix with Enterobius vermicularis (pinworm) infestation, the most common parasite present in appendectomy specimens worldwide. Although intussusception in young adults is an uncommon occurrence, the unique nature of this case is amplified by the concurrent finding of E. vermicularis infection of the appendix in an adolescent in western Canada, a phenomenon normally observed in paediatric populations with higher incidence in tropical areas. Although the mechanism of intussusception in this patient remains unclear, it is hypothesised that E. vermicularis colonisation acted as an irritant stimulating intestinal hypercontractility with resulting intussusception. Successful medical eradication of the pinworm in this individual may prevent future recurrence.

Large-bowel obstruction secondary to Enterobius vermicularis pseudotumour

“…E. vermicularis has been reported as the nidus for intussusception in a number of case reports. In both a 16-year-old man and 20-year-old woman, an operative reduction was performed 13 14. In contrast, conservative management was employed in an 8-year old boy with intestinal obstruction, and on follow-up colonoscopy, multiple E. vermicularis worms were identified 15…”

Burden of parasitic infection and its impact on growth of children with hepatitis C Virus

“…In Egypt there is a high infection rate of intestinal parasites especially in the rural areas 10 . Children suffering of HCV are considered immunocompromised which makes them vulnerable to a wide spectrum of parasitic infections, especially in a nonhygienic environment and lack of sanitation measures 11 . Parasitic (helminths and protozoal) infections may lead to variety of medical problems such as irritable bowel syndrome, chronic fatigue syndrome, food allergies, colic, anorexia, abdominal distension, anxiety and reactive arthritis 12 , iron-deficiency anemia, malnutrition, growth failure and disturbance of cognitive functions 13 .…”

Intususcepción yeyuno-yeyunal por hiperperistaltismo, ¿causa o coincidencia?: imágenes clínicas

“…3 Aunque el mecanismo por el cual se origina la intususcepción no ha sido bien definido, algunos autores han propuesto que el hiperperistaltismo puede ser un factor causal. 4 La imagen tomográfica presentada es de una paciente de 18 años de edad con dolor abdominal tipo cólico, intermitente, localizado en epigastrio y acompañado de vómito en varias ocasiones. La paciente decidió acudir a urgencias debido al incremento súbito y sostenido del dolor después de aproximadamente 3 horas de iniciado el cuadro clínico.…”