Unusual Cause for Massive Pediatric Lower Gastrointestinal Bleed with Atypical Postoperative Intestinal Sequelae

Abstract

findings were obscured by excessive bowel gas and demonstrated dilated bowel loops and probable volvulus of the small bowel. The child was adequately resuscitated with intravenous fluids, antibiotics and red cell transfusion. As the child was critically ill, no further imaging was done. Once stabilized, an exploratory laparotomy was performed which revealed the jejunum and ileum filled with 150-200 roundworms with volvulus and extensive gangrene of the ileum (Figure 1). The ileum showed areas of impending rupture and seropurulent discharge on its serosal surface. The necrotic bowel containing worms was immediately resected (Figure 2). By milking the proximal bowel, more worms were expressed out and copious amounts of altered blood were